Individual
EBONY MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 247-2580
Mailing address
6309 MACK AVE, DETROIT, MI 48207-2302
(313) 247-2580
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023142
MI
1041C0700X
Clinical Social Worker
6451023142
MI
Other
Enumeration date
08/29/2024
Last updated
09/04/2024
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