Doctor Name: | STEPHANIE MILLER |
NPI Number: | 1245663186 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW, CADC |
License Number: | |
Business Practice Address: | 141 Citation Way Unit 5 Hailey, ID - 833335104 |
Business Phone Number: | 2085782222 |
Business Fax Number: | |
Mailing Address: | 190 E Bannock St, BOISE |
State: | ID |
Postal Code: | 837126241 |
Phone Number: | 2083818738 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2013 |
NPI Last Update Date: | 06/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |