Provider Demographics
NPI:1588195010
Name:MILLER, REBECCA
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32979 W WALLS RD
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-6362
Mailing Address - Country:US
Mailing Address - Phone:541-561-0442
Mailing Address - Fax:
Practice Address - Street 1:32979 W WALLS RD
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-6362
Practice Address - Country:US
Practice Address - Phone:541-561-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-26
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst