Provider Demographics
NPI:1972896199
Name:MILLER, SHERRIEL LATRICE
Entity Type:Individual
Prefix:
First Name:SHERRIEL
Middle Name:LATRICE
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 1:2970 HUDSON BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4771
Mailing Address - Country:US
Mailing Address - Phone:832-495-3095
Mailing Address - Fax:
Practice Address - Street 1:5085 W PARK BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2592
Practice Address - Country:US
Practice Address - Phone:469-277-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TX343602355S0801X
TX5265103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant