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NPI Code Detail

MEDICARE: DOMINIC MULROY LMHC

MEDICARE:   DOMINIC  MULROY  LMHC
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
1101YM0800XMental Health Counselor0185861NM

General Provider Information

NPI Number : 1407384217
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIC MULROY LMHC
Provider Business Mailing Address
First Line : 759 US HIGHWAY 84
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-3976
Country : US
Telephone Number : 505-280-5776
Fax Number : 505-426-0190
Provider Business Practice Location Address
First Line : 312 BIBB INDUSTRIAL DR
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-6287
Country : US
Telephone Number : 505-425-8120
Fax Number : 505-426-0190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2017
Last Update Date : 05/24/2017

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Directions to “ DOMINIC MULROY LMHC” Practice Location

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