Individual
DONALD MULLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
231 W MAIN ST, SUITE 1 WEST, CARBONDALE, IL 62901-2948
(618) 203-2869
Mailing address
231 W MAIN ST, SUITE 1 WEST, CARBONDALE, IL 62901-2948
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.004084
IL
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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