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NPI Code Detail

MEDICARE: SUSAN MILLER BCBA, LBA

MEDICARE: SUSAN MILLER BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-14-15911CA

General Provider Information

NPI Number : 1053724344
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MILLER BCBA, LBA
Provider Business Mailing Address
First Line : 500 FAIRWAY DR
Second Line : SUITE 102
City : DEERFIELD BEACH
State : FL
Zip : 33441-1814
Country : US
Telephone Number : 888-880-9270
Fax Number : 954-342-0273
Provider Business Practice Location Address
First Line : 11607 SOUTHFORK AVE BLDG B
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-5220
Country : US
Telephone Number : 225-244-9495
Fax Number : 954-342-0273
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 10/24/2022

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