Individual
SERITA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 BEATTY DR, GRAND PRAIRIE, TX 75052-6405
(646) 750-8236
Mailing address
430 BEATTY DR, GRAND PRAIRIE, TX 75052-6405
(646) 750-8236
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
TX
Other
Enumeration date
01/23/2023
Last updated
04/04/2023
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