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General NPI Number Information
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NPI Number | 1811467574
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Entity Type | Organization
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Legal Business Name | MULICK PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 120 14TH AVE APT 5
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City | SEATTLE
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State | WA
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Zip | 98122-5559
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Country | US
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Telephone | 503-830-8974
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Fax |
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Provider Business Mailing Address
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Address Line | 120 14TH AVE APT 5
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City | SEATTLE
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State | WA
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Zip | 98122-5559
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Country | US
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Telephone | 503-830-8974
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MELISSA R MULICK
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Credential | PSYD, LP
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Telephone | 503-830-8974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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