Doctor Name: | KRISTAL MULLINS |
NPI Number: | 1003152257 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC |
License Number: | 1692 |
Business Practice Address: | 322 Middleburg St Liberty, KY - 425393004 |
Business Phone Number: | 6067879472 |
Business Fax Number: | |
Mailing Address: | 130 Southen School Road, SOMERSET |
State: | KY |
Postal Code: | 42501 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/17/2012 |
NPI Last Update Date: | 05/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |