MEDICARE: EMILY EVANS MUELLER LCSW

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	104100000X	Social Worker	7380	FL
2	1041C0700X	Clinical Social Worker	7380	FL

General Provider Information

NPI Number	:	1104826171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY EVANS MUELLER LCSW

Provider Business Mailing Address
First Line	:	CMR 467 BOX 1726
Second Line	:
City	:	APO
State	:	AE
Zip	:	09096-0018
Country	:	US
Telephone Number	:	314-590-1440
Fax Number	:

Provider Business Practice Location Address
First Line	:	CMR 402
Second Line	:
City	:	APO
State	:	AE
Zip	:	09180
Country	:	US
Telephone Number	:	314-590-1440
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	11/04/2022

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