Individual
RICHARD MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IADC
Contact information
Practice address
301 E 4TH ST, VILLISCA, IA 50864-1146
(712) 438-1044
Mailing address
PO BOX 1, VILLISCA, IA 50864-0001
(712) 438-1044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12011
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141021
—
IA
Enumeration date
11/16/2015
Last updated
09/22/2024
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