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Individual

JADA MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.S.

Contact information

Practice address
2122 S 114TH LN, AVONDALE, AZ 85323-9184
(623) 703-2834
(623) 478-1863
Mailing address
2122 S 114TH LN, AVONDALE, AZ 85323-9184
(623) 703-2834
(623) 478-1863

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3924598
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3924598
STATE CERTIFICATION
AZ
Enumeration date
09/25/2007
Last updated
07/09/2008
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