Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 64216 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 64216 | TX |
N | 101YM0800X | Mental Health Counselor | 64216 | TX |
N | 101YP1600X | Pastoral Counselor | 64216 | TX |
Y | 101YP2500X | Professional Counselor | 64216 | TX |
NPI | 1174878276 |
---|---|
Provider Name | Ms. Deirdre E. Miller |
First Address | Manvel, TX 77578-3222 |
Second Address | Manvel, TX 77578-3222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 16/07/2012 |