Provider Demographics
NPI:1114649126
Name:MULHOLLAND, SYDNEY KATHERINE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:KATHERINE
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 N INTERSTATE 35 APT 620
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2074
Mailing Address - Country:US
Mailing Address - Phone:573-268-4801
Mailing Address - Fax:
Practice Address - Street 1:9320 ALICE MAE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5450
Practice Address - Country:US
Practice Address - Phone:512-222-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122959225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist