Amanda Lee Miller

Individual provider Active NPI Behavior Technician · Mattawan, MI

NPI 1780429993 · NPPES record last updated Jun 28, 2024

Key facts

NPI
1780429993
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
23200 Red Arrow Hwy
Mattawan, MI 49071-7774
Phone
(269) 355-6621
NPI assigned
Jun 28, 2024
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

23200 Red Arrow Hwy
Mattawan, MI 49071-7774

Mailing address

23200 Red Arrow Hwy
Mattawan, MI 49071-7774

Other providers in Mattawan, MI

All providers in Mattawan, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.