Healthcare Provider Details

I. General information

NPI: 1245286046
Provider Name (Legal Business Name): STEPHANIE RUDI MUELLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 US HIGHWAY 421 SOUTH
BUIES CREEK NC
27506-0457
US

IV. Provider business mailing address

PO BOX 457
BUIES CREEK NC
27506-0457
US

V. Phone/Fax

Practice location:
  • Phone: 910-893-9727
  • Fax: 910-893-6404
Mailing address:
  • Phone: 910-893-9727
  • Fax: 910-893-6404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3975
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: