Individual
DERRICK MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 CARGO CT, LOUISVILLE, KY 40299-1938
(502) 749-6764
Mailing address
1700 CARGO CT, LOUISVILLE, KY 40299-1938
(502) 749-6764
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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