Provider Demographics
NPI:1740988633
Name:MILLER, TYLER JADE
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JADE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TYLER
Other - Middle Name:JADE
Other - Last Name:BARBERBRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 BANKS AVE
Mailing Address - Street 2:
Mailing Address - City:MCADOO
Mailing Address - State:PA
Mailing Address - Zip Code:18237-2508
Mailing Address - Country:US
Mailing Address - Phone:570-802-3099
Mailing Address - Fax:
Practice Address - Street 1:1510 VALLEY CENTER PKWY
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2267
Practice Address - Country:US
Practice Address - Phone:484-795-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician