Individual
REO KIM MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
711 COMMERCE ST STE 204, TACOMA, WA 98402-4514
(603) 692-8173
Mailing address
768 SW OAK RD, PORT ORCHARD, WA 98367-8119
(781) 704-8563
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
BA60772446
WA
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-09-5710
BCBA
—
01
—
BA60772446
WASHINGTON STATE LICENSURE
—
Enumeration date
12/19/2012
Last updated
11/18/2020
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