Individual
AUDREY MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1010 FAIRWAY DR, FREEPORT, IL 61032-6600
(815) 599-6340
Mailing address
31488 MIDDLE CREEK RD, LANARK, IL 61046-9039
(815) 499-2045
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008765
IL
225X00000X
Occupational Therapist
4432
SC
Other
Enumeration date
07/13/2017
Last updated
03/15/2023
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