Most Relevant Information
Provider Data
| NPI Number: | 1003483926 |
| Provider Name: | CRYSTAL BROCK MULLINS LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCSW0000004304 |
Most Important Dates
| Enumeration Date: | 06/09/2021 |
| Last Updated: | 06/09/2021 |
Provider Practice Location
THE SANCTUARY
300 TYLER ROAD, SUITE 203
OAK RIDGE
TN
37830
Practice Location Phone/Fax
| Phone: | 8652452333 |
| Fax: |
Provider Mailing Location
260 MOUNTAIN DR
LENOIR CITY
TN
377726971
Provider Mailing Phone/Fax
| Phone: | 8659369230 |
| Fax: |