Provider Demographics
NPI:1215557350
Name:GRAHAM MULLINS, AMY LYNN (LMHC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:GRAHAM MULLINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:3131 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4432
Mailing Address - Country:US
Mailing Address - Phone:786-255-2586
Mailing Address - Fax:
Practice Address - Street 1:3131 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4432
Practice Address - Country:US
Practice Address - Phone:786-255-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-18
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health