Healthcare Provider Details

I. General information

NPI: 1265297287
Provider Name (Legal Business Name): ANGELA MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35200 DEQUINDRE RD
STERLING HEIGHTS MI
48310-4837
US

IV. Provider business mailing address

3159 CARPENTERS PARK RD
DAVIDSVILLE PA
15928-9223
US

V. Phone/Fax

Practice location:
  • Phone: 586-826-8600
  • Fax:
Mailing address:
  • Phone: 814-408-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: