Healthcare Provider Details

I. General information

NPI: 1881559979
Provider Name (Legal Business Name): BRINKLEY KAMALANI MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15116 N COTTON LN
SURPRISE AZ
85388-9618
US

IV. Provider business mailing address

17537 W DALEA DR
GOODYEAR AZ
85338-5869
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-8250
  • Fax:
Mailing address:
  • Phone: 623-322-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: