Provider Demographics
NPI:1912343633
Name:MULLICAN, SENIA GAIL (MA-SLP)
Entity Type:Individual
Prefix:
First Name:SENIA
Middle Name:GAIL
Last Name:MULLICAN
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-3617
Mailing Address - Country:US
Mailing Address - Phone:931-668-4022
Mailing Address - Fax:931-668-1732
Practice Address - Street 1:2548 MORRISON ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-3617
Practice Address - Country:US
Practice Address - Phone:931-668-4022
Practice Address - Fax:931-668-1732
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist