Provider Demographics
NPI:1851369177
Name:MULLINS, SHARON M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:MULLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2000 E 15TH ST
Mailing Address - Street 2:BLDG 100F
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6697
Mailing Address - Country:US
Mailing Address - Phone:405-330-8733
Mailing Address - Fax:
Practice Address - Street 1:2000 E 15TH ST
Practice Address - Street 2:BLDG 100F
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6697
Practice Address - Country:US
Practice Address - Phone:405-330-8733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK830103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist