Provider Demographics
NPI:1700043684
Name:MILLER, STACEY ALISON (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:ALISON
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-0453
Mailing Address - Country:US
Mailing Address - Phone:833-436-3832
Mailing Address - Fax:
Practice Address - Street 1:4400 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137
Practice Address - Country:US
Practice Address - Phone:833-436-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS