Provider Demographics
NPI:1700010725
Name:MILLER, VICTORIA A (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:A
Other - Last Name:UNDERKOFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 E WICONISCO ST
Mailing Address - Street 2:
Mailing Address - City:MUIR
Mailing Address - State:PA
Mailing Address - Zip Code:17957-9710
Mailing Address - Country:US
Mailing Address - Phone:717-877-2676
Mailing Address - Fax:
Practice Address - Street 1:104 E WICONISCO ST
Practice Address - Street 2:
Practice Address - City:MUIR
Practice Address - State:PA
Practice Address - Zip Code:17957-9710
Practice Address - Country:US
Practice Address - Phone:717-877-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst