Individual
LORI MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHC, CASAC
Contact information
Practice address
4108 MAKYES RD, SYRACUSE, NY 13215-8708
(315) 751-4704
Mailing address
4108 MAKYES RD, SYRACUSE, NY 13215-8708
(315) 751-4704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20064
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01079267
—
NY
Enumeration date
09/29/2008
Last updated
03/03/2024
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