Individual
MR. G. MILES MULLERVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
33 COLLEGE HILL RD, STE 30E, WARWICK, RI 02886-2776
(401) 821-6070
(401) 821-6047
Mailing address
33 COLLEGE HILL RD, STE 30E, WARWICK, RI 02886-2776
(401) 821-6070
(401) 821-6047
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW00149
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036550
BEACON HEALTH
—
01
—
30449-0
BLUE CROSS
—
Enumeration date
05/14/2007
Last updated
03/09/2011
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