Provider Demographics
NPI:1396461729
Name:MILLER, TACOYA RENEE (RBT)
Entity type:Individual
Prefix:MRS
First Name:TACOYA
Middle Name:RENEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:TACOYA
Other - Middle Name:RENEE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HUGHES
Mailing Address - Street 1:1500 S DOUGLAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:844-854-1116
Mailing Address - Fax:
Practice Address - Street 1:31557 SCHOOLCRAFT RD STE 200
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1848
Practice Address - Country:US
Practice Address - Phone:734-530-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician