MEDICARE: MS. BARBARA A MULLEN MA LMFT

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	106H00000X	Marriage & Family Therapist	MFT #32	HI

General Provider Information

NPI Number	:	1902031818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA A MULLEN MA LMFT

Provider Business Mailing Address
First Line	:	41-033 MANANA ST
Second Line	:
City	:	WAIMANALO
State	:	HI
Zip	:	96795
Country	:	US
Telephone Number	:	808-535-0153
Fax Number	:	808-536-1836

Provider Business Practice Location Address
First Line	:	1314 S KING ST
Second Line	:	STE 862
City	:	HONOLULU
State	:	HI
Zip	:	96817-3950
Country	:	US
Telephone Number	:	808-527-4474
Fax Number	:	808-536-1836

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

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	03/31/2010

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