Doctor Name: | BRIAN QUINN MILLER |
NPI Number: | 1194056374 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2 N Water Sapulpa, OK - 74066 |
Business Phone Number: | 9182240225 |
Business Fax Number: | |
Mailing Address: | Po Box 81, GLENPOOL |
State: | OK |
Postal Code: | 740330081 |
Phone Number: | 9188273711 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2010 |
NPI Last Update Date: | 01/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |