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General NPI Number Information
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NPI Number | 1215547278
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Entity Type | Individual
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Provider Name | MADELINE MILLER
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Gender | Female
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 4222 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-1628
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Country | US
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Telephone | 836-456-7148
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 MORGAN WIELAND LN APT 15-107
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City | LAKELAND
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State | FL
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Zip | 33813-3195
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Country | US
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Telephone | 800-686-5614
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-82969
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License Number State | FL
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