Individual
MICHAELA ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR TECHNICIAN
Contact information
Practice address
872 W MAIN ST APT FF259, MOLALLA, OR 97038-8862
(971) 407-8978
Mailing address
872 W MAIN ST APT FF259, MOLALLA, OR 97038-8862
(971) 407-8978
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92042612
HEALTH RECORD NUMBER
OR
Enumeration date
09/17/2019
Last updated
09/17/2019
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