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General NPI Number Information
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NPI Number | 1760755771
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Entity Type | Individual
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Provider Name | DAVID D MULLINS LMFT
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Gender | Male
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 624 HWY 51
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City | BROOKHAVEN
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State | MS
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Zip | 39601-0000
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Country | US
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Telephone | 601-823-2345
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Fax | 601-824-0349
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Provider Business Mailing Address
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Address Line | P.O. BOX 88
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City | BRANDON
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State | MS
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Zip | 39043-0088
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Country | US
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Telephone | 601-824-0342
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Fax | 601-824-0349
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0406
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License Number State | MS
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