Provider Demographics
NPI:1790739605
Name:MULCAHEY, MARY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:MULCAHEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-3220
Mailing Address - Country:US
Mailing Address - Phone:513-871-9174
Mailing Address - Fax:513-871-4850
Practice Address - Street 1:2121 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-3220
Practice Address - Country:US
Practice Address - Phone:513-871-9174
Practice Address - Fax:513-871-4850
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4788103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist