Individual
MATT THOMAS MULLENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 COMMONWEALTH PL STE 200-1045, VIRGINIA BEACH, VA 23464-4517
(757) 255-8282
Mailing address
2577 LOTUS CREEK DR, VIRGINIA BEACH, VA 23456-6450
(757) 255-8282
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012845
VA
Other
Enumeration date
08/29/2023
Last updated
04/16/2024
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