Individual
MS. MIRA LOUDA MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
3245 HOSPITAL DRIVE, JUNEAU, AK 99801
(907) 364-4432
(907) 364-1539
Mailing address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-2411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
550
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550
STATE OF ALASKA
AK
Enumeration date
11/19/2008
Last updated
10/04/2010
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