Healthcare Provider Details

I. General information

NPI: 1508356668
Provider Name (Legal Business Name): CASSANDRE M MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 SE 36TH ST
SAVANNAH GA
31404-3309
US

IV. Provider business mailing address

1208 SE 36TH ST
SAVANNAH GA
31404-3309
US

V. Phone/Fax

Practice location:
  • Phone: 912-712-2090
  • Fax:
Mailing address:
  • Phone: 864-982-3912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: