Individual
MRS. JUANITA THERESA MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SP
Contact information
Practice address
885 HOWLAND WILSON RD NE, WARREN, OH 44484-2115
(330) 856-2107
(330) 856-2107
Mailing address
885 HOWLAND WILSON RD NE, WARREN, OH 44484-2115
(330) 856-2107
(330) 856-2107
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-2820
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217945
ANTHEM
OH
05
—
8674500
—
OH
Enumeration date
02/07/2007
Last updated
10/16/2015
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