Individual
MRS. JODIE ANNE MULLANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
36 COMMERCE WAY, WOBURN, MA 01801
(781) 454-7974
(781) 938-1106
Mailing address
32 LEBANON STREET, WINCHESTER, MA 01890
(781) 454-5974
(781) 938-1106
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1016241
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468707
MAGELLAN
—
01
—
P04746
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/28/2006
Last updated
07/08/2007
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