Individual
MENESSAH MULLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC, CYC-P
Contact information
Practice address
108 W WATERFORD ST, WAKARUSA, IN 46573-2008
(574) 404-3147
Mailing address
PO BOX 232, WAKARUSA, IN 46573-0232
(574) 404-3147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39004133A
IN
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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