Provider Demographics
NPI:1508606294
Name:MAHONY, AOIFE CHRISTIN
Entity type:Individual
Prefix:
First Name:AOIFE
Middle Name:CHRISTIN
Last Name:MAHONY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 OAKLEAF DR APT C
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-9111
Mailing Address - Country:US
Mailing Address - Phone:813-508-5856
Mailing Address - Fax:
Practice Address - Street 1:519 OAKLEAF DR APT C
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-9111
Practice Address - Country:US
Practice Address - Phone:813-508-5856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker