Provider Demographics
NPI:1619226511
Name:MILLER, CHRISTINA A (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
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 1:24 MEADOW LARK RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1910
Mailing Address - Country:US
Mailing Address - Phone:888-859-7749
Mailing Address - Fax:888-859-7749
Practice Address - Street 1:500 S BURNT MILL RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2205
Practice Address - Country:US
Practice Address - Phone:888-859-7749
Practice Address - Fax:888-859-7749
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-12-11569103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst