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General NPI Number Information
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NPI Number | 1902466493
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Entity Type | Individual
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Provider Name | JACQUELINE CELIA MILLER
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 1500 21ST AVE S STE 2600B
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City | NASHVILLE
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State | TN
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Zip | 37212-3160
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Country | US
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Telephone | 615-322-7565
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Fax |
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Provider Business Mailing Address
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Address Line | 1203 HILLMEADE DR
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City | NASHVILLE
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State | TN
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Zip | 37221-5206
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Country | US
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Telephone | 214-714-7312
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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