Individual
LYNETTE MAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 PECONIC ST APT 38B, RONKONKOMA, NY 11779-7112
(631) 747-7988
Mailing address
500 PECONIC ST APT 38B, RONKONKOMA, NY 11779-7112
(631) 747-7988
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
654222
NY
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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