Individual
MS. JILL MULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MSED, BCBA
Contact information
Practice address
30 CLINTON ST, SOUTH PORTLAND, ME 04106-4914
(207) 408-2701
Mailing address
3545 82ND ST APT 51, JACKSON HEIGHTS, NY 11372-5138
(209) 471-2212
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1031160
—
174400000X
Specialist
1130497
NY
Other
Enumeration date
01/09/2012
Last updated
07/10/2019
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