MEDICARE: DR. MARY ANN MULCAHEY PH.D.

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
1	103T00000X	Psychologist	4788	OH

General Provider Information

NPI Number	:	1790739605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ANN MULCAHEY PH.D.

Provider Business Mailing Address
First Line	:	2121 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-3220
Country	:	US
Telephone Number	:	513-871-9174
Fax Number	:	513-871-4850

Provider Business Practice Location Address
First Line	:	2121 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-3220
Country	:	US
Telephone Number	:	513-871-9174
Fax Number	:	513-871-4850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	05/09/2008

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