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General NPI Number Information
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NPI Number | 1932890357
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Entity Type | Individual
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Provider Name | EMANI ONDREA PURIFOY MILLER
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | ADDRESS: 33464 SCHOENHERR RD 180
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312
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Country | US
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Telephone | 313-671-6593
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Fax |
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Provider Business Mailing Address
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Address Line | EPURIFOY@GATWAYPEDIATRICTHERAPY.COM 2928 HUNT STREET
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City | DETROIT
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State | MI
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Zip | 48207
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Country | US
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Telephone | 313-671-6593
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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