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General NPI Number Information
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NPI Number | 1831756238
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Entity Type | Individual
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Provider Name | MARC KEDAR MUELLER LMHC
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Gender | Male
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 314 27TH ST NE
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City | PUYALLUP
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State | WA
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Zip | 98372-3105
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Country | US
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Telephone | 253-350-4386
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 301
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City | SUMNER
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State | WA
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Zip | 98390-0060
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Country | US
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Telephone | 253-350-4386
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61262920
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60945630
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License Number State | WA
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