Healthcare Provider Details

I. General information

NPI: 1043619190
Provider Name (Legal Business Name): MARTHA MULLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 N FLORIDA AVE
DELAND FL
32720-3483
US

IV. Provider business mailing address

317 N FLORIDA AVE
DELAND FL
32720-3483
US

V. Phone/Fax

Practice location:
  • Phone: 386-868-5373
  • Fax:
Mailing address:
  • Phone: 386-868-5373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT2790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: