Healthcare Provider Details

I. General information

NPI: 1770811499
Provider Name (Legal Business Name): DEBORAH MUELLER L.L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 DIXIE HWY
IRA MI
48023-1755
US

IV. Provider business mailing address

PO BOX 138
ANCHORVILLE MI
48004-0138
US

V. Phone/Fax

Practice location:
  • Phone: 586-924-9905
  • Fax:
Mailing address:
  • Phone: 586-924-9905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401010907
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: