MEDICARE: KACEE MULLIKIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1902753635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KACEE MULLIKIN

Provider Business Mailing Address
First Line	:	606 W RICHARDS ST
Second Line	:
City	:	OVERTON
State	:	TX
Zip	:	75684-1510
Country	:	US
Telephone Number	:	903-354-5654
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 DODD ST
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75603-5815
Country	:	US
Telephone Number	:	430-558-1335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ KACEE MULLIKIN ” Practice Location

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