Individual
MIA MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
522 SANDIA ST APT B, SANTA FE, NM 87501-1320
(505) 570-5188
Mailing address
903 W ALAMEDA ST # 803, SANTA FE, NM 87501-1681
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7105
NM
Other
Enumeration date
08/13/2018
Last updated
06/26/2026
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