Provider Demographics
NPI:1588039481
Name:MILLER, AYLA MARIAH MARISSA (CADC)
Entity Type:Individual
Prefix:
First Name:AYLA MARIAH
Middle Name:MARISSA
Last Name:MILLER
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:AYLA
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1863 VAN EPPS DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4847
Mailing Address - Country:US
Mailing Address - Phone:775-297-5630
Mailing Address - Fax:
Practice Address - Street 1:5540 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2599
Practice Address - Country:US
Practice Address - Phone:775-480-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NV06599-C101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical