Provider Demographics
NPI:1710724265
Name:HOUSTON, MOLLY JEAN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:JEAN
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 ASHLAND LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1492
Mailing Address - Country:US
Mailing Address - Phone:301-300-0829
Mailing Address - Fax:
Practice Address - Street 1:4550 FLORENCE DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5507
Practice Address - Country:US
Practice Address - Phone:970-679-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0007137225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist