| NPI | 1922581396 | 
|---|---|
| Former Name | TAMARA ANN MULLIS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2018-09-12 | 
| Last Update Date | 2024-02-28 |