Individual
MS. DEBORAH R MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC-SC, LICDC, LSW
Contact information
Practice address
5727 ROWENA DR, DAYTON, OH 45415-2445
(937) 361-4834
(937) 588-5877
Mailing address
5727 ROWENA DR, DAYTON, OH 45415-2445
(937) 361-4834
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
021106
OH
101YP2500X
Professional Counselor
Primary
E 0002479
OH
1041C0700X
Clinical Social Worker
S 0004990
OH
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2272231
—
OH
Enumeration date
12/13/2005
Last updated
11/08/2024
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