Healthcare Provider Details

I. General information

NPI: 1831597145
Provider Name (Legal Business Name): ALISA MULHOLLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2014
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 PINELLAS BAYWAY S APT 306
TIERRA VERDE FL
33715-1995
US

IV. Provider business mailing address

545 PINELLAS BAYWAY S APT 306
TIERRA VERDE FL
33715-1995
US

V. Phone/Fax

Practice location:
  • Phone: 410-689-9033
  • Fax:
Mailing address:
  • Phone: 410-689-9033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: