Provider Demographics
NPI:1699188318
Name:MUELLER, ANDREW WILFORD (MA, LGPC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:WILFORD
Last Name:MUELLER
Suffix:
Gender:M
Credentials:MA, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2432
Mailing Address - Country:US
Mailing Address - Phone:410-626-1800
Mailing Address - Fax:
Practice Address - Street 1:92 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2432
Practice Address - Country:US
Practice Address - Phone:410-626-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP5434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional