Provider Demographics
NPI:1750758983
Name:KATHERINE H. MUELLNER, PLLC
Entity type:Organization
Organization Name:KATHERINE H. MUELLNER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:507-281-3033
Mailing Address - Street 1:6005 SALEM RD SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-8825
Mailing Address - Country:US
Mailing Address - Phone:507-281-3033
Mailing Address - Fax:507-281-7692
Practice Address - Street 1:6005 SALEM RD SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-8825
Practice Address - Country:US
Practice Address - Phone:507-281-3033
Practice Address - Fax:507-281-7692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN507101YP2500X
MN42261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty