Theodora Marie Miller | Las Vegas, NV • PECOS Search

Theodora Marie Miller

Counselor

Behavioral Health & Social Service Providers

121 S Martin L King Blvd, Las Vegas, NV 89106-4309

(702) 486-5362 (702) 395-5672

PECOS Enrollment

Based on the most recent information from CMS, provider Theodora Marie Miller does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1780984666
Provider Type
Individual
Full Name
Miller, Theodora Marie
Credential
MSED

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/26/2010
Last Updated
10/26/2010

Contact Information

Practice Location

121 S Martin L King Blvd, Las Vegas, NV 89106-4309

Unlisted Fax

Mailing Location

6920 Rosinwood St, Las Vegas, NV 89131-3597

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer