Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 14670 | TX |
NPI | 1003016379 |
---|---|
Provider Name | Mr. David A Miller |
First Address | Austin, TX 78701-2072 |
Second Address | Austin, TX 78701-2072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 22/08/2014 |