Provider Demographics
NPI:1760643191
Name:MULLINS, SONJA MARIE (BS)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:MARIE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38558-8821
Mailing Address - Country:US
Mailing Address - Phone:931-787-6693
Mailing Address - Fax:931-525-6970
Practice Address - Street 1:1420 NEAL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4333
Practice Address - Country:US
Practice Address - Phone:931-525-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health