Doctor Name: | BRENDA S MULLEN |
NPI Number: | 1730578873 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC007875 |
Business Practice Address: | 113 Sumner St Cresson, PA - 166302118 |
Business Phone Number: | 8143304588 |
Business Fax Number: | |
Mailing Address: | 113 Sumner Street, CRESSON |
State: | PA |
Postal Code: | 16630 |
Phone Number: | 8143304588 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2015 |
NPI Last Update Date: | 02/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC007875 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |