Provider Demographics
NPI:1447983721
Name:MILLER, RACQUEL
Entity type:Individual
Prefix:MS
First Name:RACQUEL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RACQUEL
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NBCHWC
Mailing Address - Street 1:332 N DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08312-1522
Mailing Address - Country:US
Mailing Address - Phone:856-237-3671
Mailing Address - Fax:
Practice Address - Street 1:332 N DELSEA DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08312-1522
Practice Address - Country:US
Practice Address - Phone:856-237-3671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJA-327885171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty