Provider Demographics
NPI:1962819474
Name:MILLER, JESSICA WHITNEY (BCABA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:WHITNEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 CAMPERS LN
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-1427
Mailing Address - Country:US
Mailing Address - Phone:540-220-0721
Mailing Address - Fax:
Practice Address - Street 1:881 CAMPERS LN
Practice Address - Street 2:
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-1427
Practice Address - Country:US
Practice Address - Phone:540-220-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst