Individual
ELIZABETH MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 CALLE RAMON, SANTA FE, NM 87501-8936
(505) 983-0805
Mailing address
1316 CALLE RAMON, SANTA FE, NM 87501-8936
(505) 983-0805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-04705
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75302829
—
NM
Enumeration date
05/03/2007
Last updated
07/08/2007
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