Provider Demographics
NPI:1598970113
Name:MULLOY SCARLETT, LAURA L (AP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MULLOY SCARLETT
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:L
Other - Last Name:MULLOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AP
Mailing Address - Street 1:500 NE 5TH AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5663
Mailing Address - Country:US
Mailing Address - Phone:561-272-7816
Mailing Address - Fax:561-272-7566
Practice Address - Street 1:500 NE 5TH AVE STE 5
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5663
Practice Address - Country:US
Practice Address - Phone:561-272-7816
Practice Address - Fax:561-272-7566
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL438171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist