Individual
LAUREN JENNIFER MULLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., OTR/L
Contact information
Practice address
3022 CHISHOLM CT, WAXHAW, NC 28173-7865
(704) 843-1007
(704) 843-1007
Mailing address
3022 CHISHOLM CT, WAXHAW, NC 28173-7865
(704) 843-1007
(704) 843-1007
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6110
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1424U
BCBS
NC
05
—
7301928
—
NC
Enumeration date
11/02/2006
Last updated
07/08/2007
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