Doctor Name: | JAVONNE MULLINS |
NPI Number: | 1801274071 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 22896 |
Business Practice Address: | 33466 Calle Miramar San Juan Capistrano, CA - 926754921 |
Business Phone Number: | 7406067775 |
Business Fax Number: | |
Mailing Address: | 33466 Calle Miramar, SAN JUAN CAPISTRANO |
State: | CA |
Postal Code: | 926754921 |
Phone Number: | 7406067775 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2015 |
NPI Last Update Date: | 08/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |