Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC003686 | PA |
NPI | 1003897588 |
---|---|
Provider Name | Ms. Diane Mw Miller |
First Address | Lebanon, PA 17042-5230 |
Second Address | Gettysburg, PA 17325-1930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 08/07/2007 |