MEDICARE: KAIRA MILLER

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
1	103K00000X	Behavior Analyst	BEH-001683	AZ

General Provider Information

NPI Number	:	1114686334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAIRA MILLER

Provider Business Mailing Address
First Line	:	3530 S VAL VISTA DR STE 209
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-7322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 S VAL VISTA DR STE 209
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-7322
Country	:	US
Telephone Number	:	623-244-9272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	12/17/2025

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