Provider Demographics
NPI:1356500714
Name:JEAN MULLOY PHD INC
Entity Type:Organization
Organization Name:JEAN MULLOY PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MULLOY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-875-0728
Mailing Address - Street 1:730 S STERLING AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4542
Mailing Address - Country:US
Mailing Address - Phone:813-875-0728
Mailing Address - Fax:
Practice Address - Street 1:730 S STERLING AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4542
Practice Address - Country:US
Practice Address - Phone:813-875-0728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5467103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty