Individual
MARY MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
269 1ST ST, PITTSFIELD, MA 01201-4727
(413) 499-9515
Mailing address
269 1ST ST, PITTSFIELD, MA 01201-4727
(413) 499-9515
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
115824-SW-LICSW
MA
156FX1202X
Optometric Technician
115824-SW-LICSW
MA
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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