Provider Demographics
NPI:1891709051
Name:MULLER, TERRY P (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:P
Last Name:MULLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 HANSEN RD
Mailing Address - Street 2:SUITE 202-D
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8839
Mailing Address - Country:US
Mailing Address - Phone:434-296-2900
Mailing Address - Fax:434-296-2101
Practice Address - Street 1:154 HANSEN RD
Practice Address - Street 2:SUITE 202-D
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8839
Practice Address - Country:US
Practice Address - Phone:434-296-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002298103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA089777OtherANTHEM
VA7223486OtherAETNA
VA13563OtherCIGNA
VA7714131Medicare ID - Type Unspecified
VA680000363Medicare ID - Type Unspecified