Provider Demographics
NPI:1316563216
Name:MILLER, JANAE JAZMEEN (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JANAE
Middle Name:JAZMEEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 SHORELINE WALK
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7639
Mailing Address - Country:US
Mailing Address - Phone:973-518-1988
Mailing Address - Fax:
Practice Address - Street 1:165 SHORELINE WALK
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-7639
Practice Address - Country:US
Practice Address - Phone:973-518-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-20-42616103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty