Provider Demographics
NPI:1871927756
Name:MILLER, ISRAEL BENSON (BCBA)
Entity type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:BENSON
Last Name:MILLER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 SWEET WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-5840
Mailing Address - Country:US
Mailing Address - Phone:801-376-0213
Mailing Address - Fax:
Practice Address - Street 1:2839 SWEET WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5840
Practice Address - Country:US
Practice Address - Phone:801-376-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst