Individual
DR. KACY MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503
(541) 826-2111
Mailing address
17650 HIGHWAY 238, GRANTS PASS, OR 97527-8616
(972) 623-8470
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2457
OR
Other
Enumeration date
10/31/2013
Last updated
07/13/2018
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