Individual
JAWAN MULLEN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDAC INTERN
Contact information
Practice address
5940 MOONDANCE CT, HENDERSON, NV 89011-4921
(703) 269-7616
Mailing address
5940 MOONDANCE CT, HENDERSON, NV 89011-4921
(703) 269-7616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08256-1
NV
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
05/28/2026
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