Provider Information for 1386186096
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CIARRA WATERS-MULLEN
Sex: Female
NPI: 1386186096
Last Updated: 2024-01-31
Certification Date: 2024-01-31
Certification Date: 2024-01-31
Details
Name | Value | ||||||||||||
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NPI | 1386186096 | ||||||||||||
Enumeration Date | 2016-11-11 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 3701 CONTI ST APT 3223 NEW ORLEANS, LA 70119-5334 United States Phone: 510-717-0498 | Fax: | ||||||||||||
Primary Practice Address | 3701 CONTI ST APT 3223 NEW ORLEANS, LA 70119-5334 United States Phone: 510-717-0498 | Fax: | ||||||||||||
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