Healthcare Provider Details

I. General information

NPI: 1952268948
Provider Name (Legal Business Name): MS. LESLIE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8141 TELEGRAPH RD
SEVERN MD
21144-3256
US

IV. Provider business mailing address

9527 N LAUREL RD
LAUREL MD
20723-1845
US

V. Phone/Fax

Practice location:
  • Phone: 410-672-2862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: