Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 10823 | MD |
NPI | 1003166679 |
---|---|
Provider Name | John Paul Mulhern |
First Address | Hagerstown, MD 21740-5721 |
Second Address | Frederick, MD 21701-5614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2012 |
Last Update Date | 11/09/2012 |