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General NPI Number Information
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NPI Number | 1477170686
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Entity Type | Organization
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Legal Business Name | MULLINS SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 63 NICOLAUS DR
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City | HATTIESBURG
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State | MS
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Zip | 39402-8113
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Country | US
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Telephone | 601-303-1116
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Fax | 601-255-8630
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Provider Business Mailing Address
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Address Line | 63 NICOLAUS DR
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City | HATTIESBURG
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State | MS
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Zip | 39402-8113
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Country | US
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Telephone | 601-731-0997
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Fax | 601-255-8630
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEVEN KYLE MULLINS
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Credential | CCC-SLP
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Telephone | 601-731-0997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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