Provider Demographics
NPI:1407414519
Name:MCMULLIN, STEFNEE
Entity Type:Individual
Prefix:MS
First Name:STEFNEE
Middle Name:
Last Name:MCMULLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-1856
Mailing Address - Country:US
Mailing Address - Phone:517-420-0995
Mailing Address - Fax:
Practice Address - Street 1:4 S 2600 W STE 6
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3247
Practice Address - Country:US
Practice Address - Phone:435-229-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health