NPI 1629632039 · live from the CMS NPI Registry
Jennessa Rose Miller, BA
Behavior Analyst in Galena, AK. National Provider Identifier 1629632039, active.
NPI record
| NPI | 1629632039 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 77 Antoski Drive, Galena, AK 99741 |
| Practice phone | 907-656-1366 |
| Mailing address | Po Box 77, Galena, AK 99741 |
| Enumerated | May 1, 2019 |
| Last updated | May 1, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.