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NPI Code Detail

MEDICARE: HEATHER MARIE MILLER

MEDICARE: HEATHER MARIE 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
1106S00000XBehavior Technician
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1295119071
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER MARIE MILLER
Provider Business Mailing Address
First Line : 740 WILLOW LAKE CIR APT 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-7960
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3101 MAGIC HOLLOW BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23453-3010
Country : US
Telephone Number : 757-639-2218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2015
Last Update Date : 06/17/2019

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Directions to “ HEATHER MARIE MILLER ” Practice Location

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