| Doctor Name: | MS. CONNIE GENE MILLER |
| NPI Number: | 1770564635 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW CADC |
| License Number: | CADC 1088005 |
| Business Practice Address: | 1115 B St Plummer, ID - 83851 |
| Business Phone Number: | 2086861449 |
| Business Fax Number: | |
| Mailing Address: | 3405 N Park Rd, SPOKANE VALLEY |
| State: | WA |
| Postal Code: | 992121508 |
| Phone Number: | 5099270497 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CADC 1088005 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |