Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YM0800X | Mental Health Counselor | 004649 | NY |
NPI | 1003040379 |
---|---|
Provider Name | Stephanie L Miller |
First Address | Saratoga Springs, NY 12866-4723 |
Second Address | Saratoga Springs, NY 12866-4723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 27/07/2011 |