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NPI Code Detail

MEDICARE: ANTHONY & DENISE MULLENHOUR

MEDICARE: ANTHONY & DENISE MULLENHOUR
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
11041C0700XClinical Social Worker24005898AIN

General Provider Information

NPI Number : 1275935447
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTHONY & DENISE MULLENHOUR
Provider Business Mailing Address
First Line : 9256 ANDIRON DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-1486
Country : US
Telephone Number : 317-441-2131
Fax Number : 317-876-3600
Provider Business Practice Location Address
First Line : 3307 W 96TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1106
Country : US
Telephone Number : 317-441-2131
Fax Number : 317-876-3600
Authorized Official
Title or Position : PARTNER
Name : DENISE MULLENHOUR
Credential : LCSW
Telephone Number : 317-441-2131
Provider Enumeration Date : 09/19/2014
Last Update Date : 09/19/2014

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