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General NPI Number Information
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NPI Number | 1750146122
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Entity Type | Individual
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Provider Name | SALVADOR MURILLO LPC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 3365 S 103RD ST STE 100
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City | MILWAUKEE
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State | WI
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Zip | 53227-4162
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Country | US
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Telephone | 414-321-3951
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Fax | 414-321-8307
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Provider Business Mailing Address
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Address Line | 3733 S 16TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53221-1621
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Country | US
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Telephone | 414-750-0821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10806-125
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License Number State | WI
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