Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003409327 |
---|---|
Provider Name | Joshua Miller |
First Address | Henderson, NV 89074-8162 |
Second Address | Henderson, NV 89014-2260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2021 |
Last Update Date | 17/02/2021 |