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NPI Code Detail

MEDICARE: JUDEE L MULHOLLEN ED.D., M.ED., LSW

MEDICARE: JUDEE L MULHOLLEN ED.D., M.ED., LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorS-0028458OH

General Provider Information

NPI Number : 1679794879
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDEE L MULHOLLEN ED.D., M.ED., LSW
Provider Business Mailing Address
First Line : 12115 LISA ST NW
Second Line :
City : HARTVILLE
State : OH
Zip : 44632-9637
Country : US
Telephone Number : 330-354-9543
Fax Number :
Provider Business Practice Location Address
First Line : 10 PENFIELD AVE
Second Line :
City : AKRON
State : OH
Zip : 44310-2912
Country : US
Telephone Number : 330-762-6110
Fax Number : 330-253-6810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 08/16/2024

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