Provider Demographics
NPI:1952643751
Name:MILLER, ELLIOTT PHILLIP (BCBA)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:PHILLIP
Last Name:MILLER
Suffix:
Gender:M
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:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-0802
Mailing Address - Country:US
Mailing Address - Phone:828-277-1315
Mailing Address - Fax:828-277-1321
Practice Address - Street 1:6 ROBERTS RD STE 105
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8699
Practice Address - Country:US
Practice Address - Phone:282-771-3158
Practice Address - Fax:828-277-1321
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-13-13196103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst