Individual
PETER MULLEN
Active
Individual
PETER MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2561-PY-PR
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2561-PY-PR
PSYCHOLOGY LICENSE
MA
Enumeration date
05/07/2018
Last updated
06/16/2018
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