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General NPI Number Information
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NPI Number | 1588631352
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Entity Type | Individual
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Provider Name | TINA H. MULL OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16717 US HIGHWAY 17 N SUITE 206
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City | HAMPSTEAD
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State | NC
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Zip | 28443-3088
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Country | US
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Telephone | 910-270-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 107 CAVALIER DR
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City | WILMINGTON
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State | NC
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Zip | 28403-0301
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Country | US
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Telephone | 910-509-7444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4375
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License Number State | NC
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