# MRS. JUANITA THERESA MCMULLEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1689714164
- **Gender:** F
- **Credential:** SP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | SP-2820 | OH | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 10/16/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000217945 | ANTHEM | OH |
| 05 | — | 8674500 | — | OH |