Provider Demographics
NPI:1427743145
Name:MOLINA, MARITZA (MA, LPC-A)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19926 CYPRESSWOOD SQ
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-3286
Mailing Address - Country:US
Mailing Address - Phone:281-224-2053
Mailing Address - Fax:
Practice Address - Street 1:301 N THOMPSON ST STE 215
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2893
Practice Address - Country:US
Practice Address - Phone:346-298-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88415101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor