Provider Demographics
NPI:1336592211
Name:MUELLER, LAURA BETH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BETH
Last Name:MUELLER
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 1:424 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1748
Mailing Address - Country:US
Mailing Address - Phone:989-390-1230
Mailing Address - Fax:248-634-7754
Practice Address - Street 1:424 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1748
Practice Address - Country:US
Practice Address - Phone:989-390-1230
Practice Address - Fax:248-634-7754
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010958011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical