Provider Demographics
NPI:1528652682
Name:MUIRHEAD, ULYSA MASHELL (RBT, QMHP A/C)
Entity type:Individual
Prefix:MRS
First Name:ULYSA
Middle Name:MASHELL
Last Name:MUIRHEAD
Suffix:
Gender:F
Credentials:RBT, QMHP A/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 BROCKIE ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8005
Mailing Address - Country:US
Mailing Address - Phone:757-995-6877
Mailing Address - Fax:
Practice Address - Street 1:780 LYNNHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-301-9065
Practice Address - Fax:866-499-8840
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst