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NPI Code Detail

MEDICARE: ANNETTE MAHONEY PH.D.

MEDICARE: ANNETTE MAHONEY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist4879OH

General Provider Information

NPI Number : 1215140421
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE MAHONEY PH.D.
Provider Business Mailing Address
First Line : 16307 W POE RD
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-8715
Country : US
Telephone Number : 419-308-4070
Fax Number : 419-372-6013
Provider Business Practice Location Address
First Line : 1941 CARLIN ST
Second Line :
City : FINDLAY
State : OH
Zip : 45840-1460
Country : US
Telephone Number : 419-422-8616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/08/2007

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Directions to “ ANNETTE MAHONEY PH.D.” Practice Location

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