Healthcare Provider Details

I. General information

NPI: 1871458257
Provider Name (Legal Business Name): HOLLY C MILLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 OAKFIELD DR
BRANDON FL
33511-4938
US

IV. Provider business mailing address

3013 WILTON LN
VALRICO FL
33596-5661
US

V. Phone/Fax

Practice location:
  • Phone: 801-995-1709
  • Fax:
Mailing address:
  • Phone: 801-995-1709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5376
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: