Provider Demographics
NPI:1487147245
Name:MULLNER, DUANE F
Entity type:Individual
Prefix:
First Name:DUANE
Middle Name:F
Last Name:MULLNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6383 SECREST ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7484
Mailing Address - Country:US
Mailing Address - Phone:303-985-3534
Mailing Address - Fax:
Practice Address - Street 1:807 ARAPAHOE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1032
Practice Address - Country:US
Practice Address - Phone:303-985-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty