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General NPI Number Information
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NPI Number | 1649466541
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Entity Type | Individual
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Provider Name | JADA MILLER ED.S.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 2122 S 114TH LN
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City | AVONDALE
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State | AZ
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Zip | 85323-9184
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Country | US
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Telephone | 623-703-2834
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Fax | 623-478-1863
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Provider Business Mailing Address
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Address Line | 2122 S 114TH LN
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City | AVONDALE
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State | AZ
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Zip | 85323-9184
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Country | US
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Telephone | 623-703-2834
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Fax | 623-478-1863
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 3924598
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License Number State | AZ
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