Individual
KACIE MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
218 ALPINE TRL, KINGSPORT, TN 37663-2994
(317) 519-4618
Mailing address
218 ALPINE TRL, KINGSPORT, TN 37663-2994
(317) 519-4618
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119637
TX
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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