Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103K00000X | Behavior Analyst | ||
N | 225XM0800X | Mental Health |
NPI | 1467008060 |
---|---|
Provider Name | Christen Miller |
First Address | Fayetteville, NC 28303-3201 |
Second Address | Burlington, NC 27215-5332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2019 |
Last Update Date | 11/08/2019 |