Individual
GINA MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1443 HARTFORD AVENUE, JOHNSTON, RI 02919
(401) 273-8100
(401) 861-8696
Mailing address
1443 HARTFORD AVE, JOHNSTON, RI 02919-3224
(401) 273-8100
(401) 861-8696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDP00421
RI
1041C0700X
Clinical Social Worker
Primary
ISW02357
RI
Other
Enumeration date
06/30/2008
Last updated
10/29/2019
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