Doctor Name: | MS. DIANE MILLER |
NPI Number: | 1518100858 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCDC I |
License Number: | CCDC I |
Business Practice Address: | 200 Paul Gust Rd Chamberlain, SD - 573251031 |
Business Phone Number: | 6057345290 |
Business Fax Number: | 6057340965 |
Mailing Address: | 200 Paul Gust Rd, CHAMBERLAIN |
State: | SD |
Postal Code: | 573251031 |
Phone Number: | 6057345290 |
Fax Number: | 6057340965 |
NPI Enumeration Date: | 04/16/2009 |
NPI Last Update Date: | 04/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CCDC I |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |