Provider Demographics
NPI:1639324833
Name:MILLER, DANA LAUREN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LAUREN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 NE 17TH WAY
Mailing Address - Street 2:APT 3
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-3444
Mailing Address - Country:US
Mailing Address - Phone:954-232-7481
Mailing Address - Fax:
Practice Address - Street 1:717 NE 17TH WAY
Practice Address - Street 2:APT 3
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3444
Practice Address - Country:US
Practice Address - Phone:954-232-7481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2021-08-13
Deactivation Date:2019-03-04
Deactivation Code:
Reactivation Date:2021-08-13
Provider Licenses
StateLicense IDTaxonomies
FL1-06-3011103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst