MEDICARE: DR. CHRISTINE MARIE MULLEN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	10975412-2501	UT

General Provider Information

NPI Number	:	1083225395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE MARIE MULLEN PSYD

Provider Business Mailing Address
First Line	:	255 N 400 W APT 3
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-1233
Country	:	US
Telephone Number	:	386-503-0442
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 MEDICAL DRIVE N
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-1927
Country	:	US
Telephone Number	:	801-581-2932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	09/06/2023

Similar Medicare Providers

1902952864 — DR. MELISSA DIANE YOUNG PHARMD
Practice Location Address:

1212 S 1300 E
SALT LAKE CITY, UT
84105-1927

Practice Phone: 801-557-9904
Practice Fax: --

1063734341 — RETA NICHOLE MANWILL DEM
Practice Location Address:

270 COATSVILLE AVE
SALT LAKE CITY, UT
84115-1927

Practice Phone: 801-415-9888
Practice Fax: 801-521-0196

1881055168 — LUCKY IYE
Practice Location Address:

175 S MAIN ST STE 500
SALT LAKE CITY, UT
84111-1927

Practice Phone: 801-856-3174
Practice Fax:

1902610983 — DIANA WEIL CNS, CD
Practice Location Address:

222 E COATSVILLE AVE
SALT LAKE CITY, UT
84115-1927

Practice Phone: 801-910-4285
Practice Fax:

1811961105 — DR. MICHELLE JARVIS WALTON D.C.
Practice Location Address:

4727 GAILLARDIA PKWY STE 140
OKLAHOMA CITY, OK
73142-1927

Practice Phone: 405-936-4688
Practice Fax:

1881669232 — MRS. SONYA LECK PA-C
Practice Location Address:

4727 GAILLARDIA PKWY STE 140
OKLAHOMA CITY, OK
73142-1927

Practice Phone: 405-623-7348
Practice Fax:

Directions to “ DR. CHRISTINE MARIE MULLEN PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.