Provider Demographics
NPI:1740016625
Name:ABDULLAH, MARY MUELLERLEILE (MASTER CASAC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MUELLERLEILE
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:MASTER CASAC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MUELLERLEILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:313 MILL ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:391 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2571
Practice Address - Country:US
Practice Address - Phone:845-275-5699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)