Provider Demographics
NPI:1891435285
Name:MILLER, MAKAYLA M (BCBA)
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:M
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 1:40 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-5711
Mailing Address - Country:US
Mailing Address - Phone:800-355-2583
Mailing Address - Fax:
Practice Address - Street 1:7 REGENT ST STE 708
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1628
Practice Address - Country:US
Practice Address - Phone:551-237-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst