Doctor Name: | MRS. LAVERNE BEAL MILLER |
NPI Number: | 1265553952 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED |
License Number: | |
Business Practice Address: | 425 N 1st St Immokalee, FL - 341423150 |
Business Phone Number: | 2396574434 |
Business Fax Number: | 2396574331 |
Mailing Address: | 4951 22nd St Ne, NAPLES |
State: | FL |
Postal Code: | 341200405 |
Phone Number: | 2396574434 |
Fax Number: | 2396574331 |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |