Provider Demographics
NPI:1285065052
Name:MILLER, TRUBE CASSANDRA (PHD)
Entity type:Individual
Prefix:DR
First Name:TRUBE
Middle Name:CASSANDRA
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5118 HOLLY WAY
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5969
Mailing Address - Country:US
Mailing Address - Phone:903-818-5979
Mailing Address - Fax:
Practice Address - Street 1:5118 HOLLY WAY
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5969
Practice Address - Country:US
Practice Address - Phone:903-818-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64745101YP2500X
TX1-17-26192103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional