Doctor Name: | MARY A MUMMAW |
NPI Number: | 1730313552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 1224 |
Business Practice Address: | 5671 N Skeel Ave Oscoda, MI - 487501535 |
Business Phone Number: | 9897392550 |
Business Fax Number: | 9893583750 |
Mailing Address: | 5671 N Skeel Ave, OSCODA |
State: | MI |
Postal Code: | 487501535 |
Phone Number: | 9897392550 |
Fax Number: | 9893583750 |
NPI Enumeration Date: | 05/07/2009 |
NPI Last Update Date: | 01/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1224 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |