# MARY A MOULIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710334040
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN.335272 | OH | — |
| 163WA0400X | Addiction (Substance Use Disorder) Registered Nurse | RN.335272 | OH | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | RN.335272 | OH | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | RN335272 | OH | — |

## Other

- **Enumeration date:** 05/17/2016
- **Last updated:** 06/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2910854 | — | OH |