Individual
AMY JEAN MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.007004-S
OH
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0338913
—
OH
Enumeration date
10/25/2014
Last updated
05/28/2025
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