Doctor Name: | LAVINA JO MILLER |
NPI Number: | 1003946831 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., L.L.P. |
License Number: | 6301010641 |
Business Practice Address: | 3760 Cleary Dr Howell, MI - 488438542 |
Business Phone Number: | 5175480081 |
Business Fax Number: | 5175480498 |
Mailing Address: | 2280 E Grand River Ave, HOWELL |
State: | MI |
Postal Code: | 488438503 |
Phone Number: | 5175464126 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301010641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |