MEDICARE: DEBORAH MUELLER L.L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6401010907	MI

General Provider Information

NPI Number	:	1770811499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH MUELLER L.L.P.C.

Provider Business Mailing Address
First Line	:	PO BOX 138
Second Line	:
City	:	ANCHORVILLE
State	:	MI
Zip	:	48004-0138
Country	:	US
Telephone Number	:	586-924-9905
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 DIXIE HWY
Second Line	:
City	:	IRA
State	:	MI
Zip	:	48023-1755
Country	:	US
Telephone Number	:	586-924-9905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	11/19/2009

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