Provider Demographics
NPI:1790482826
Name:MILLER, DEQUARREIONNA ARQUZHA
Entity Type:Individual
Prefix:
First Name:DEQUARREIONNA
Middle Name:ARQUZHA
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 1:9729 HIGHLAND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-4247
Mailing Address - Country:US
Mailing Address - Phone:727-312-6989
Mailing Address - Fax:
Practice Address - Street 1:9729 HIGHLAND RIDGE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-4247
Practice Address - Country:US
Practice Address - Phone:727-312-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician