Individual
CAROL ANN MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9370 ECKERMAN RD, ROSEVILLE, CA 95661-5911
(916) 899-0294
Mailing address
9370 ECKERMAN RD, ROSEVILLE, CA 95661-5911
(916) 899-0294
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING ENUMERATION
K.I.S.S. HOUSE, WOMEN IN RECOVERY
CA
Enumeration date
10/21/2008
Last updated
10/21/2008
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