Provider Demographics
NPI:1871789958
Name:MULLER, ERVENA CATRESE
Entity type:Individual
Prefix:MS
First Name:ERVENA
Middle Name:CATRESE
Last Name:MULLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ERVENA
Other - Middle Name:CATRESE
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4056 STARKS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-9499
Mailing Address - Country:US
Mailing Address - Phone:803-481-0662
Mailing Address - Fax:
Practice Address - Street 1:525 N LAFAYETTE DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4347
Practice Address - Country:US
Practice Address - Phone:803-775-6293
Practice Address - Fax:803-775-3651
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health