Individual
ISABELLA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 EDWARDSVILLE RD, TROY, IL 62294-1339
(314) 275-0506
Mailing address
2147 WATERMAN AVE, GRANITE CITY, IL 62040-4002
(618) 514-8624
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-333418
IL
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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