Provider Demographics
NPI:1942787148
Name:MILLER, MINERVA PASQUIN
Entity Type:Individual
Prefix:MRS
First Name:MINERVA
Middle Name:PASQUIN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MINERVA
Other - Middle Name:GONZALEZ
Other - Last Name:PASQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95-061 WAIKALANI DR APT D805
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3370
Mailing Address - Country:US
Mailing Address - Phone:808-429-9833
Mailing Address - Fax:
Practice Address - Street 1:95-061 WAIKALANI DR APT D805
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3370
Practice Address - Country:US
Practice Address - Phone:808-429-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician