Provider Demographics
NPI:1689367732
Name:MUIRHEAD, DONNA MARIE (RBT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:MUIRHEAD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 RIVERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1323
Mailing Address - Country:US
Mailing Address - Phone:774-245-7739
Mailing Address - Fax:
Practice Address - Street 1:103 RIVERS EDGE DR
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1323
Practice Address - Country:US
Practice Address - Phone:774-245-7739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARBT-15-02725106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician