Healthcare Provider Details

I. General information

NPI: 1386890119
Provider Name (Legal Business Name): JOY LOUISE MILLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BUSINESS LOOP 70 W SUITE 153 A
COLUMBIA MO
65203-2585
US

IV. Provider business mailing address

2105 E NASHVILLE CHURCH RD
ASHLAND MO
65010-9069
US

V. Phone/Fax

Practice location:
  • Phone: 573-499-4572
  • Fax:
Mailing address:
  • Phone: 573-999-2380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1999136659
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: