Healthcare Provider Details

I. General information

NPI: 1619403516
Provider Name (Legal Business Name): DARIAN YEA MILLER MFT-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14625 NE 23RD ST
CHOCTAW OK
73020-8728
US

IV. Provider business mailing address

3050 180TH AVE SE
NORMAN OK
73026-9643
US

V. Phone/Fax

Practice location:
  • Phone: 405-275-7100
  • Fax:
Mailing address:
  • Phone: 405-593-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFTCANDIDATE12160
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: