Individual
GRACE MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGY INTERN
Contact information
Practice address
312 3RD ST, ELYRIA, OH 44035-5618
(440) 323-5707
Mailing address
312 3RD ST ENTRANCE HOLLY LANE, ELYRIA, OH 44035-1217
(440) 323-5707
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
OH
172V00000X
Community Health Worker
—
OH
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/24/2018
Last updated
08/31/2022
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