Michaela Ann Miller, BEHAVIOR TECHNICIAN

Individual provider Active NPI Behavior Technician · Molalla, OR

NPI 1235789652 · NPPES record last updated Sep 17, 2019

Key facts

NPI
1235789652
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
872 W Main St Apt Ff259
Molalla, OR 97038-8862
Phone
(971) 407-8978
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

872 W Main St Apt Ff259
Molalla, OR 97038-8862

Mailing address

872 W Main St Apt Ff259
Molalla, OR 97038-8862
Phone (971) 407-8978

Other identifiers

IdentifierTypeStateIssuer
92042612OtherORHEALTH RECORD NUMBER

Other providers in Molalla, OR

All providers in Molalla, OR · Behavior Technician in Oregon

Sources for this page

Verify at the official NPI Registry.