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General NPI Number Information
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NPI Number | 1447787080
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Entity Type | Individual
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Provider Name | HEATHER MCMULLEN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2017
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 580 BELLERIVE DR STE AB
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City | ANNAPOLIS
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State | MD
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Zip | 21409-4602
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Country | US
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Telephone | 443-703-8087
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Fax |
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Provider Business Mailing Address
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Address Line | 15 TRUCK HOUSE RD
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City | SEVERNA PARK
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State | MD
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Zip | 21146-2714
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Country | US
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Telephone | 443-703-8087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20357
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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