Doctor Name: | MRS. MELISSA D MILLER |
NPI Number: | 1023370566 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC006814 |
Business Practice Address: | 326 Myrtle Crossing Dr Ste 100 Statesboro, GA - 304584429 |
Business Phone Number: | 9127647001 |
Business Fax Number: | 9124896864 |
Mailing Address: | 326 Myrtle Crossing Dr Ste 100, STATESBORO |
State: | GA |
Postal Code: | 304584429 |
Phone Number: | 9127647001 |
Fax Number: | 9124896864 |
NPI Enumeration Date: | 06/11/2012 |
NPI Last Update Date: | 06/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC006814 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |