Healthcare Provider Details

I. General information

NPI: 1902466493
Provider Name (Legal Business Name): JACQUELINE CELIA MILLER MA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 COLORADO BLVD STE 102
DENTON TX
76210-6872
US

IV. Provider business mailing address

7010 KINGSBURY DR
DALLAS TX
75231-7202
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-3917
  • Fax:
Mailing address:
  • Phone: 214-714-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: