Individual
MICHELLE DAWN MULLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 E TYLER ST, MANGUM, OK 73554-3417
(580) 649-0571
Mailing address
1003 E TYLER ST, MANGUM, OK 73554-3417
(580) 649-0571
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OK
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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