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NPI Code Detail

MEDICARE: MARISSA MILLER RBT

MEDICARE: MARISSA MILLER RBT
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
1251S00000XCommunity/Behavioral Health AgencyDE
2106S00000XBehavior TechnicianNJ
3106S00000XBehavior TechnicianDE
4251S00000XCommunity/Behavioral Health AgencyNJ

General Provider Information

NPI Number : 1104793405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA MILLER RBT
Provider Business Mailing Address
First Line : 125 S WHITE HORSE PIKE APT 69
Second Line :
City : LINDENWOLD
State : NJ
Zip : 08021-2327
Country : US
Telephone Number : 302-762-2636
Fax Number :
Provider Business Practice Location Address
First Line : 510 PHILADELPHIA PIKE
Second Line :
City : WILMINGTON
State : DE
Zip : 19809-2100
Country : US
Telephone Number : 302-762-2636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2025
Last Update Date : 03/18/2026

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Directions to “ MARISSA MILLER RBT” Practice Location

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