Provider Demographics
NPI:1093128696
Name:MULLINEAUX, LISA G (MS,CGC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:G
Last Name:MULLINEAUX
Suffix:
Gender:F
Credentials:MS,CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 E MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5734
Mailing Address - Country:US
Mailing Address - Phone:303-734-3969
Mailing Address - Fax:303-734-2095
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 380
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2648
Practice Address - Country:US
Practice Address - Phone:303-734-3969
Practice Address - Fax:303-734-2095
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS