Healthcare Provider Details

I. General information

NPI: 1649648353
Provider Name (Legal Business Name): RYAN DANIELLE MILLER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14402 DAYTON PIKE # D
SALE CREEK TN
37373-7823
US

IV. Provider business mailing address

14402 DAYTON PIKE STE D
SALE CREEK TN
37373-7823
US

V. Phone/Fax

Practice location:
  • Phone: 423-855-7376
  • Fax:
Mailing address:
  • Phone: 423-451-6898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1067
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: