Provider Demographics
NPI:1730481037
Name:MULVILLE, ADRIENNE MICHELLE (LAC, MOM)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MICHELLE
Last Name:MULVILLE
Suffix:
Gender:F
Credentials:LAC, MOM
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MICHELLE
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:559 S HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1229
Mailing Address - Country:US
Mailing Address - Phone:952-240-1138
Mailing Address - Fax:
Practice Address - Street 1:3310 WARREN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2031
Practice Address - Country:US
Practice Address - Phone:216-476-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000198171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist