Provider Demographics
NPI:1891048427
Name:MARTIN MULVEY, LYNN ELIZABETH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ELIZABETH
Last Name:MARTIN MULVEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:ELIZABETH
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:N5367 MAYFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:SHIOCTON
Mailing Address - State:WI
Mailing Address - Zip Code:54170-8934
Mailing Address - Country:US
Mailing Address - Phone:920-986-3003
Mailing Address - Fax:920-986-3004
Practice Address - Street 1:N5367 MAYFLOWER RD
Practice Address - Street 2:
Practice Address - City:SHIOCTON
Practice Address - State:WI
Practice Address - Zip Code:54170-8934
Practice Address - Country:US
Practice Address - Phone:920-986-3003
Practice Address - Fax:920-986-3004
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical