Provider Demographics
NPI:1831786961
Name:MILLER, MEGAN N
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:N
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 1:45-1030 WAILELE RD
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3153
Mailing Address - Country:US
Mailing Address - Phone:720-352-8985
Mailing Address - Fax:
Practice Address - Street 1:45-1030 WAILELE RD
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3153
Practice Address - Country:US
Practice Address - Phone:720-352-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician