Provider Demographics
NPI:1437992997
Name:MULA BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:MULA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MULA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-671-3674
Mailing Address - Street 1:502 W 37TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1715
Mailing Address - Country:US
Mailing Address - Phone:773-671-3674
Mailing Address - Fax:
Practice Address - Street 1:708 CHURCH ST STE 252
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3840
Practice Address - Country:US
Practice Address - Phone:773-671-3674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty