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General NPI Number Information
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NPI Number | 1821511742
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Entity Type | Individual
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Provider Name | DAVID LEE MUELLER
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Gender | Male
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 07/23/2017
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Provider Practice Location Address
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Address Line | 2849B HENDERSON MILL RD
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City | ATLANTA
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State | GA
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Zip | 30341-5772
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Country | US
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Telephone | 404-419-6221
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Fax |
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Provider Business Mailing Address
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Address Line | 104 CORNETT LN S
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City | JASPER
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State | GA
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Zip | 30143-5826
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Country | US
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Telephone | 770-893-8657
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC009123
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License Number State | GA
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