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Individual

MR. STEVEN KYLE MULLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CCC-SLP

Contact information

Practice address
63 NICOLAUS DR, HATTIESBURG, MS 39402-8113
(601) 731-0997
Mailing address
63 NICOLAUS DR, HATTIESBURG, MS 39402-8113
(601) 731-0997

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3670
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00387057
MS
05
09051792
MS
01
140249
UNITED HEALTHCARE
MS
01
QMP000005828403
MOLINA
MS
Enumeration date
11/05/2012
Last updated
10/03/2024
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