Provider Demographics
NPI:1689414021
Name:MULLINS, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4369 S HOWELL AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-5055
Mailing Address - Country:US
Mailing Address - Phone:414-999-0102
Mailing Address - Fax:
Practice Address - Street 1:4369 S HOWELL AVE STE 306
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-5055
Practice Address - Country:US
Practice Address - Phone:414-999-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health