Individual
KIMBERLY REGINA MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17575 HAVENS REST RD., ABINGDON, VA 24210
(276) 608-7984
Mailing address
17571 HAVENS REST RD, ABINGDON, VA 24210-8085
(276) 608-7984
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000457
VA
224Z00000X
Occupational Therapy Assistant
406097
TN
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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