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Search › Ohio › 101YA0400X

Mollie Countryman

NPI 1194348334 · on the registry since 2020 · sole proprietor

Practice

Address
323 N Broad St
Fairborn, OH 45324
Phone
(937) 318-8103
Fax
(937) 400-2347
Organisation at this address
Fairborn Mental Health Llc
Fairborn Mental Health Llc
Fairborn Mental Health Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
12

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Also registered as
171M00000X
Sex
Female
Record last updated
2021-05-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio