Provider Demographics
NPI:1376965293
Name:MUELLER, MARLA DAHL (LPC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:DAHL
Last Name:MUELLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E. 21 ST.
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001
Mailing Address - Country:US
Mailing Address - Phone:307-220-0154
Mailing Address - Fax:
Practice Address - Street 1:217 E. 21 ST.
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001
Practice Address - Country:US
Practice Address - Phone:307-220-0154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-12
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0013065101Y00000X
WYLPC-1784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor