Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1275813040 |
---|---|
Provider Name | Eric Miller |
First Address | Urbana, IL 61801-3116 |
Second Address | Urbana, IL 61801-3116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2011 |
Last Update Date | 24/08/2011 |