Provider Demographics
NPI:1043381445
Name:MULLEN, CHRISTINE E (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:MULLEN
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:E
Other - Last Name:BIXLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1605 ST RT 60
Mailing Address - Street 2:STE 3
Mailing Address - City:VERMILLION
Mailing Address - State:OH
Mailing Address - Zip Code:44089
Mailing Address - Country:US
Mailing Address - Phone:440-967-2508
Mailing Address - Fax:440-967-4023
Practice Address - Street 1:1605 ST RT 60
Practice Address - Street 2:STE 3
Practice Address - City:VERMILLION
Practice Address - State:OH
Practice Address - Zip Code:44089
Practice Address - Country:US
Practice Address - Phone:440-967-2508
Practice Address - Fax:440-967-4023
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP5982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist