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Individual

MISS TANYA MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1 CIVIC PLAZA DR STE 625, CARSON, CA 90745-7986
(310) 549-4500
(310) 549-4700
Mailing address
1 CIVIC PLAZA DR STE 625, CARSON, CA 90745-7986
(310) 549-4500
(310) 549-4700

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
969732
CA

Other

Enumeration date
02/17/2011
Last updated
02/17/2011
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