Healthcare Provider Details

I. General information

NPI: 1427899103
Provider Name (Legal Business Name): BRITTNEY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15384 S DIXIE HWY
MONROE MI
48161-3773
US

IV. Provider business mailing address

197 E ERIE RD
TEMPERANCE MI
48182-9348
US

V. Phone/Fax

Practice location:
  • Phone: 734-252-6522
  • Fax:
Mailing address:
  • Phone: 734-778-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: