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General NPI Number Information
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NPI Number | 1831281690
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Entity Type | Individual
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Provider Name | AMY MELISSA MULHOLLAND PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6150 DIAMOND CENTRE CT UNIT 1003
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City | FORT MYERS
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State | FL
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Zip | 33912-7135
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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 | 6150 DIAMOND CENTRE CT UNIT 1003
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City | FORT MYERS
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State | FL
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Zip | 33912-7135
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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 |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY6605
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License Number State | FL
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