Individual
MRS. DIANA K MULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9325 CR 622 G, BUSHNELL, FL 33513
(352) 568-2207
Mailing address
9325 CR 622 G, BUSHNELL, FL 33513
(352) 568-2207
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
686124596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686124596
—
FL
Enumeration date
08/21/2008
Last updated
08/21/2008
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