Individual
MARILYN MULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2672 NW SKYLEE DR APT 3, ROSEBURG, OR 97471-1989
(541) 378-4590
Mailing address
2672 NW SKYLEE DR APT 3, ROSEBURG, OR 97471-1989
(541) 378-4590
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1242
OR
261QM0850X
Adult Mental Health Clinic/Center
1242
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295901809
NPPES
OR
Enumeration date
11/18/2015
Last updated
08/08/2021
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