Healthcare Provider Details
I. General information
NPI: 1972703395
Provider Name (Legal Business Name): MS. DAISHA MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2007
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9707 KEY WEST AVE STE 100
ROCKVILLE MD
20850-3992
US
IV. Provider business mailing address
9707 KEY WEST AVE STE 100
ROCKVILLE MD
20850-3992
US
V. Phone/Fax
- Phone: 240-750-6467
- Fax: 240-912-7835
- Phone: 240-750-6467
- Fax: 240-912-7835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: