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General NPI Number Information
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NPI Number | 1942370663
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Entity Type | Individual
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Provider Name | BRENDA ANN MULLINS M.ED.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 859 WILLARD ST 4TH FLOOR
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City | QUINCY
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State | MA
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Zip | 02169-7482
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Country | US
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Telephone | 617-745-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 624 HYDE PARK AVE C-4
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City | BOSTON
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State | MA
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Zip | 02131-4302
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Country | US
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Telephone | 617-745-2774
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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