| Denise Rae Mullins | |
|
5705 Lee Farm Ln Suite D Suffolk VA 23435-1772 | |
| (757) 483-3834 | |
| (757) 483-8938 |
| Full Name | Denise Rae Mullins |
|---|---|
| Speciality | Social Worker |
| Location | 5705 Lee Farm Ln, Suffolk, Virginia |
| Authorized Official Name and Position | Denise Rae Mullins (OWNER) |
| Authorized Official Contact | 7574833834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Denise Rae Mullins 5705 Lee Farm Ln Suite D Suffolk VA 23435-1772 Ph: (757) 483-3834 | Denise Rae Mullins 5705 Lee Farm Ln Suite D Suffolk VA 23435-1772 Ph: (757) 483-3834 |
| NPI Number | 1285065979 |
|---|---|
| Provider Enumeration Date | 12/05/2013 |
| Last Update Date | 12/05/2013 |
| Medicare PECOS PAC ID | 5496973356 |
|---|---|
| Medicare Enrollment ID | O20140905002285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285065979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0710000608 (Virginia) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904001609 (Virginia) | Primary |
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