Provider Demographics
NPI:1942061163
Name:MULBAH, HELENA M
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:M
Last Name:MULBAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 W FORRESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-3109
Mailing Address - Country:US
Mailing Address - Phone:267-905-3825
Mailing Address - Fax:
Practice Address - Street 1:6 W FORRESTVIEW RD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-3109
Practice Address - Country:US
Practice Address - Phone:267-905-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PA103K00000X103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst