| Doctor Name: | TIMOTHY MULLINS |
| NPI Number: | 1588080279 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | 8511927-6010 |
| Business Practice Address: | 437 E Pine View Dr Central, UT - 847223231 |
| Business Phone Number: | 5757799419 |
| Business Fax Number: | |
| Mailing Address: | Po Box 45, SANTA CLARA |
| State: | UT |
| Postal Code: | 847650045 |
| Phone Number: | 5757799419 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2014 |
| NPI Last Update Date: | 03/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 8511927-6010 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |