Healthcare Provider Details

I. General information

NPI: 1174455729
Provider Name (Legal Business Name): RENEE N MILLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RENEE MARIE NORMAN LMFT

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 N SPARKS ST
BURBANK CA
91506-1850
US

IV. Provider business mailing address

622 N SPARKS ST
BURBANK CA
91506-1850
US

V. Phone/Fax

Practice location:
  • Phone: 818-631-2634
  • Fax:
Mailing address:
  • Phone: 818-631-2634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number29182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: