Individual
RICHARD MULRENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
120 HOSPITAL DR, STE 100, LEBANON, MO 65536-9238
(417) 533-6751
(417) 533-6755
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2011028486
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013228071
—
MO
01
—
431560263
TRICARE
MO
01
—
P01137838
MCR RR
MO
Enumeration date
06/24/2010
Last updated
03/22/2013
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