Provider Demographics
NPI:1649077009
Name:URSIN, MAIYA
Entity type:Individual
Prefix:
First Name:MAIYA
Middle Name:
Last Name:URSIN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 PADDINGTON BEND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3076
Mailing Address - Country:US
Mailing Address - Phone:609-372-7114
Mailing Address - Fax:
Practice Address - Street 1:6311 PADDINGTON BEND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3076
Practice Address - Country:US
Practice Address - Phone:832-380-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician