Provider Demographics
NPI:1942006648
Name:MCMURTRAY, MIKAYLA ANNMARIE
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:ANNMARIE
Last Name:MCMURTRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8956 RESEARCH BLVD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5969
Mailing Address - Country:US
Mailing Address - Phone:512-451-7337
Mailing Address - Fax:512-451-8729
Practice Address - Street 1:8956 RESEARCH BLVD BLDG 2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5969
Practice Address - Country:US
Practice Address - Phone:512-451-7337
Practice Address - Fax:512-451-8729
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91576101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional