Provider Demographics
NPI:1245712793
Name:MULVEY, MARIA JEAN
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JEAN
Last Name:MULVEY
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 1:7029 DEERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-6482
Mailing Address - Country:US
Mailing Address - Phone:816-726-0389
Mailing Address - Fax:
Practice Address - Street 1:LEXINGTON R-V SCHOOL DISTRICT OFFICE 2323A
Practice Address - Street 2:HIGH SCHOOL DRIVE
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067
Practice Address - Country:US
Practice Address - Phone:660-259-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001007776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist