Individual
CARL JOHN MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7797
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
07/19/2019
Last updated
07/19/2019
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