Provider Demographics
NPI:1255971248
Name:MILLER, PAUL DARNEL JR (CPST)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DARNEL
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:CPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1792 HORIZON DRIVE
Mailing Address - Street 2:A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8713
Mailing Address - Country:US
Mailing Address - Phone:330-554-5368
Mailing Address - Fax:
Practice Address - Street 1:1792 HORIZON DRIVE
Practice Address - Street 2:A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8713
Practice Address - Country:US
Practice Address - Phone:330-554-5368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator