Individual
MRS. HEATHER MULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
65 DARCEE CT, LAWRENCEVILLE, GA 30045-7402
(678) 858-4777
(678) 985-3953
Mailing address
4370 SATELLITE BLVD APT 620, DULUTH, GA 30096-4060
(678) 858-4777
(678) 985-3953
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6927
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226858618A
—
GA
Enumeration date
10/14/2008
Last updated
10/14/2008
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