Most Relevant Information
Provider Data
| NPI Number: | 1003476599 |
| Provider Name: | LISA MILLER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2019 |
| Last Updated: | 06/17/2019 |
Provider Practice Location
9351 W BROAD ST
HENRICO
VA
232945437
Practice Location Phone/Fax
| Phone: | 8045963275 |
| Fax: |
Provider Mailing Location
9351 W BROAD ST
HENRICO
VA
232945437
Provider Mailing Phone/Fax
| Phone: | 8045963275 |
| Fax: |