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1962058826
MICHAEL JOHN MCMULLEN
FARGO, ND
NPI
1962058826
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ND 1859)
Enumeration Date
2019-08-15
Last Update Date
2019-08-15
Business Address
MICHAEL JOHN MCMULLEN LAC
4227 9TH AVE S
FARGO, ND 58103-2018
Phone number: 701-781-6021
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Mailing Address
MICHAEL JOHN MCMULLEN LAC
4227 9TH AVE S
FARGO, ND 58103-2018
Phone number: 701-781-6021
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