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Individual
DR. MARYLOU MYLANT
Active
Individual
DR. MARYLOU MYLANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RN, PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R025102
SD
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
R025102
SD
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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