Healthcare Provider Details

I. General information

NPI: 1447530241
Provider Name (Legal Business Name): ELIZABETH ANN MUEHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 2ND ST
EUREKA CA
95501-0811
US

IV. Provider business mailing address

3370 L K WOOD BLVD APT D
ARCATA CA
95521-8217
US

V. Phone/Fax

Practice location:
  • Phone: 707-269-9590
  • Fax: 707-444-8012
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: