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General NPI Number Information
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NPI Number | 1275712911
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN FAMILY PSYCHOLOGY
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 13430 PARKER COMMONS BLVD STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-1812
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Country | US
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Telephone | 239-561-9955
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Fax | 239-561-9779
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Provider Business Mailing Address
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Address Line | 13430 PARKER COMMONS BLVD STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-1812
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Country | US
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Telephone | 239-561-9955
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Fax | 239-561-9779
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Authorized Official
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Title or Position | CO OWNER/PSYCHOLOGIST
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Name | DR. AMY MULHOLLAND
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Credential | PH.D.
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Telephone | 239-561-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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