Individual
TINA MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
175 PHILPOT LANE, BEAVER, WV 25813
(304) 254-9262
Mailing address
PO BOX 1124, BEAVER, WV 25813-1124
(304) 253-1112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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