MARY MULLENBACH (NPI# 1235351826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235351826 |
| Entity Type | Individual |
| Full Name | MARY MULLENBACH |
| Credential | PHD, LP |
| Practice Address |
6550 York Ave. S. Suite 503 Minneapolis MN 55435 |
| Mailing Address |
6550 York Ave. S. Suite 503 Minneapolis MN 55435-2336 |
| Practice Telephone | 9524263034 |
| Practice Fax Number | 6125400460 |
| Mailing Telephone | 9524263034 |
| Mailing Fax Number | 6125400460 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2018-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP4360 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1235351826 | 05 |
| Street Address |
6550 YORK AVE. S. SUITE 503 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
| 1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
| 1831740216 | Seth Gordon Disner | Psychologist | 1 Veterans Dr # B68-2, Minneapolis, MN 55417-2309 | 2019-09-26 |
| 1366090763 | Healing Therapy LLC | Psychologist | 1813 S 6th St Ste 201, Minneapolis, MN 55454-1208 | 2019-08-28 |
| 1891340469 | Karin Fisher | Psychologist | 701 Park Ave # S1.260, Minneapolis, MN 55415-1623 | 2019-08-09 |
| 1053881698 | Lauren Michelle Scholder | Psychologist | 401 Main St Se Apt 7009, Minneapolis, MN 55414 | 2018-11-27 |
| 1902306038 | Ksa Psychological Services, LLC | Psychologist | 5603 Chicago Ave., Minneapolis, MN 55417 | 2018-02-15 |
| 1689030231 | Oliver Ross Psychology and Consulting LLC | Psychologist | 3802 Grand Ave S, Suite A, Minneapolis, MN 55409-1233 | 2016-01-13 |
| 1295100881 | Oliver Ross | Psychologist | 3802a Grand Avenue South, Minneapolis, MN 55409 | 2015-12-08 |
| 1841664190 | Lakes Wellness Center LLC | Psychologist | 3248 Stevens Ave, Minneapolis, MN 55408-3214 | 2015-11-24 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55435 |
Please comment or provide details below to improve the information on MARY MULLENBACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.