Individual
JUSTIN MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4891 E COUNTY LINE RD, MINERAL RIDGE, OH 44440-9411
(567) 560-1976
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615030
—
OH
Enumeration date
02/05/2022
Last updated
02/05/2022
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