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Larry Dwayne Mullin
Peer Specialist in Vinita, Oklahoma
NPI 1538838040

Larry Dwayne Mullin is a Peer Specialist based in Afton, OK. Larry Dwayne Mullin practices in Vinita, OK. The NPI Number for Larry Dwayne Mullin is 1538838040 and holds a License No. (Oklahoma).

The current practice location address for Larry Dwayne Mullin is 405 E Excelsior Ave, Vinita, OK and can be reached out via phone at 918-325-7005.

Location: 405 E Excelsior Ave, Vinita, OK, 74331-0712
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538838040
Provider Name
Larry Dwayne Mullin
Credential
Provider Entity Type
Individual
Gender
Male
Address
405 E Excelsior Ave, Vinita, OK, 74331-0712
Phone Number
918-325-7005
Fax Number
Provider Enumeration Date
09/08/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-325-7005
Fax Number
person
Provider Business Mailing Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-325-7005
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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