Healthcare Provider Details

I. General information

NPI: 1427441096
Provider Name (Legal Business Name): KATHARINE MARIE MULLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHARINE COKER

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 W MAIN ST
CABOT AR
72023-7463
US

IV. Provider business mailing address

33 WYATT LN
VILONIA AR
72173-9462
US

V. Phone/Fax

Practice location:
  • Phone: 501-274-4422
  • Fax:
Mailing address:
  • Phone: 501-654-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: