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NPI Code Detail

MEDICARE: MRS. MADISON MILLER

MEDICARE: MRS. MADISON MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2168TX
2103K00000XBehavior Analyst1-16-24628SC

General Provider Information

NPI Number : 1629514757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MADISON MILLER
Provider Business Mailing Address
First Line : 3552 FM 1092 RD
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-2203
Country : US
Telephone Number : 346-368-4412
Fax Number : 855-742-3123
Provider Business Practice Location Address
First Line : 3552 FM 1092 RD
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-2203
Country : US
Telephone Number : 346-368-4412
Fax Number : 855-742-3123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2017
Last Update Date : 02/12/2020

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Directions to “ MRS. MADISON MILLER ” Practice Location

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