Healthcare Provider Details

I. General information

NPI: 1679794879
Provider Name (Legal Business Name): JUDEE L MULHOLLEN ED.D., M.ED., LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PENFIELD AVE
AKRON OH
44310-2912
US

IV. Provider business mailing address

12115 LISA ST NW
HARTVILLE OH
44632-9637
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-6110
  • Fax: 330-253-6810
Mailing address:
  • Phone: 330-354-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS-0028458
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: