| Doctor Name: | JENNIFER LYNN MULLENIX |
| NPI Number: | 1558651984 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., TLLP |
| License Number: | L1995256 |
| Business Practice Address: | 6195 Miller Rd Swartz Creek, MI - 484731599 |
| Business Phone Number: | 8106301152 |
| Business Fax Number: | 8106309107 |
| Mailing Address: | 7208 Charter Oaks Dr, DAVISON |
| State: | MI |
| Postal Code: | 484233310 |
| Phone Number: | 8102412928 |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2011 |
| NPI Last Update Date: | 12/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | L1995256 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |