Individual
BRIAN JERALD MUELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
8616 NORTHERN AVE, ROCKFORD, IL 61107-5309
(815) 979-3402
(815) 332-6090
Mailing address
232 MCMILLAN CT, APT. 201, CORTLAND, IL 60112-4169
(815) 299-2560
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.007967
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497002679
NATIONAL PROVIDER IDENTIFIER
IL
Enumeration date
08/07/2012
Last updated
08/05/2014
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