Provider Demographics
NPI:1811323363
Name:MULLIN, BETH (MS, BCBA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MULLIN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 JEWEL LN
Mailing Address - Street 2:#204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0716
Mailing Address - Country:US
Mailing Address - Phone:412-370-7855
Mailing Address - Fax:
Practice Address - Street 1:7737 JEWEL LN
Practice Address - Street 2:#204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0716
Practice Address - Country:US
Practice Address - Phone:412-370-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-10-3911103K00000X
FL1-14-15718103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst