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Individual

MS. CONSTANCE JOYLYN MULDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW-S, LICDC-CS

Contact information

Practice address
7048 FRONT ST, PORTSMOUTH, OH 45662-7103
(740) 456-7079
Mailing address
PO BOX 83, WHEELERSBURG, OH 45694-0083
(740) 456-7079

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
923289
OH
1041C0700X
Clinical Social Worker
Primary
0008749
OH
1041C0700X
Clinical Social Worker
3537
KY
1041C0700X
Clinical Social Worker
DP00944461
WV

Other

Enumeration date
08/31/2006
Last updated
07/28/2015
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