Healthcare Provider Details

I. General information

NPI: 1174399646
Provider Name (Legal Business Name): EMILY MILLER LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 WATER ST
ALLEGAN MI
49010-1309
US

IV. Provider business mailing address

428 WATER ST
ALLEGAN MI
49010-1309
US

V. Phone/Fax

Practice location:
  • Phone: 616-295-8284
  • Fax: 616-834-0446
Mailing address:
  • Phone: 616-295-8284
  • Fax: 616-834-0446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451025288
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: