Provider Demographics
NPI:1679794879
Name:MULHOLLEN, JUDEE L (EDD, MED, LSW)
Entity type:Individual
Prefix:
First Name:JUDEE
Middle Name:L
Last Name:MULHOLLEN
Suffix:
Gender:F
Credentials:EDD, MED, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12115 LISA ST NW
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9637
Mailing Address - Country:US
Mailing Address - Phone:330-354-9543
Mailing Address - Fax:
Practice Address - Street 1:10 PENFIELD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2912
Practice Address - Country:US
Practice Address - Phone:330-762-6110
Practice Address - Fax:330-253-6810
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-0028458101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor