Provider Demographics
NPI:1275336117
Name:MULLIN, CONSTANCE
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:MULLIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:ME
Mailing Address - Zip Code:04539-3515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1522 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:ME
Practice Address - Zip Code:04539-3515
Practice Address - Country:US
Practice Address - Phone:207-380-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical