Individual
MRS. MARY ELIZABETH MULLEN-LAVALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
30 WASHINGTON STREET, KEENE, NH 03431
(603) 357-4400
Mailing address
17 93RD ST, KEENE, NH 03431-3748
(603) 399-8147
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3104
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81263595
—
NH
Enumeration date
02/08/2007
Last updated
11/19/2007
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