Provider Demographics
NPI:1457121477
Name:MILLER, KAPRICE (MA, LBS)
Entity Type:Individual
Prefix:MS
First Name:KAPRICE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, LBS
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 771
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-0771
Mailing Address - Country:US
Mailing Address - Phone:267-745-1811
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE A52
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3705
Practice Address - Country:US
Practice Address - Phone:267-745-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005902103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst