MEDICARE: CIARA MACMULLEN RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1750237731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA MACMULLEN RBT

Provider Business Mailing Address
First Line	:	601 W BACON ST APT 3302
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-5216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16021 CONTINENTAL BLVD
Second Line	:
City	:	SOUTH CHESTERFIELD
State	:	VA
Zip	:	23834-5900
Country	:	US
Telephone Number	:	804-985-1050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ CIARA MACMULLEN RBT” Practice Location

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