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General NPI Number Information
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NPI Number | 1700940681
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Entity Type | Individual
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Provider Name | DEBORAH LYNN MULHOLLAND LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 475 N 300 W STE 14
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City | KAYSVILLE
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State | UT
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Zip | 84037-3110
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Country | US
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Telephone | 801-544-1166
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Fax | 801-546-6558
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Provider Business Mailing Address
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Address Line | 690 E CENTER ST
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City | KAYSVILLE
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State | UT
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Zip | 84037-2137
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Country | US
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Telephone | 801-698-5274
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Fax | 801-546-6558
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 51314803501
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License Number State | UT
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