Individual
MR. SHANE J MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Contact information
Practice address
2950 SW WOODSIDE DR, TOPEKA, KS 66614-5326
(785) 272-5134
(785) 272-4370
Mailing address
2001 MEADOWLARK LN, EMPORIA, KS 66801-6127
(620) 341-0865
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
052
KS
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
052
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200434290B
—
KS
Enumeration date
03/26/2007
Last updated
05/29/2015
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