Basic Information
| Provider Information | |||||||||
| NPI: | 1356627111 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULLEN | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | ELLEN TAYLOR | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1335 NW BROAD ST | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371294428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203387503 | ||||||||
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| Practice Location | |||||||||
| Address1: | 510 W FRONTVIEW ST | ||||||||
| Address2: | |||||||||
| City: | DODGE CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 678012213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202278551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2011 | ||||||||
| LastUpdateDate: | 10/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 821 | KS | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.