Provider Demographics
NPI:1245650274
Name:MULHOLLAND, JULIE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 S HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-1542
Mailing Address - Country:US
Mailing Address - Phone:859-608-3806
Mailing Address - Fax:
Practice Address - Street 1:530 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1542
Practice Address - Country:US
Practice Address - Phone:859-608-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist