Provider Demographics
NPI:1710539754
Name:BEEBE-MULHOLLAND, MARVEL A (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARVEL
Middle Name:A
Last Name:BEEBE-MULHOLLAND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2040
Mailing Address - Country:US
Mailing Address - Phone:989-723-5877
Mailing Address - Fax:
Practice Address - Street 1:1216 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2040
Practice Address - Country:US
Practice Address - Phone:989-723-5877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010970331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical