Provider Demographics
NPI:1093783516
Name:MULVANY, MALYNDA CARLENE (MED, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MALYNDA
Middle Name:CARLENE
Last Name:MULVANY
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 WOODBINE CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2202 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-5257
Practice Address - Country:US
Practice Address - Phone:402-293-4938
Practice Address - Fax:402-293-4351
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1000235Z00000X
NE5218368746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist