Healthcare Provider Details

I. General information

NPI: 1891931325
Provider Name (Legal Business Name): JANET L MULVEY M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2676 CURRYBUSH RD
ROTTERDAM NY
12306-6225
US

IV. Provider business mailing address

2676 CURRYBUSH RD
ROTTERDAM NY
12306-6225
US

V. Phone/Fax

Practice location:
  • Phone: 518-573-0479
  • Fax: 518-355-3322
Mailing address:
  • Phone: 518-573-0479
  • Fax: 518-355-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number006617
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: