Provider Demographics
NPI:1770311011
Name:MULVIHILL, JAYNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JAYNE
Middle Name:
Last Name:MULVIHILL
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 1:9266 WASHAM POTTS RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6108
Mailing Address - Country:US
Mailing Address - Phone:312-480-8211
Mailing Address - Fax:
Practice Address - Street 1:9266 WASHAM POTTS RD
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6108
Practice Address - Country:US
Practice Address - Phone:312-480-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6609101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health