Doctor Name: | MRS. LATOYIA TENNELLE MILLER |
NPI Number: | 1073912754 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1171 Rowayton Cir Wellington, FL - 334145543 |
Business Phone Number: | 5612609290 |
Business Fax Number: | |
Mailing Address: | 1171 Rowayton Cir, WELLINGTON |
State: | FL |
Postal Code: | 334145543 |
Phone Number: | 5612609290 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2014 |
NPI Last Update Date: | 08/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |