Provider Demographics
NPI:1760735690
Name:MULLINAX, JOAN E (LPC INTERN)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:MULLINAX
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CROCKER ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4340
Mailing Address - Country:US
Mailing Address - Phone:832-209-2222
Mailing Address - Fax:713-630-0821
Practice Address - Street 1:1501 CROCKER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4340
Practice Address - Country:US
Practice Address - Phone:832-209-2222
Practice Address - Fax:713-630-0821
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional