Provider Demographics
NPI:1932380367
Name:MURILLO, WOLVIN
Entity Type:Individual
Prefix:MR
First Name:WOLVIN
Middle Name:
Last Name:MURILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9421 YELLOWWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1169
Mailing Address - Country:US
Mailing Address - Phone:484-866-0270
Mailing Address - Fax:
Practice Address - Street 1:9421 YELLOW WOOD CT
Practice Address - Street 2:
Practice Address - City:BREINIGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18031
Practice Address - Country:US
Practice Address - Phone:484-866-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health