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General NPI Number Information
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NPI Number | 1134533219
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Entity Type | Individual
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Provider Name | AMY LEIGH MILLER
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Gender | Female
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 301 JUSTICE LN
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City | BUNNELL
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State | FL
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Zip | 32110-4487
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Country | US
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Telephone | 386-236-1802
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Fax |
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Provider Business Mailing Address
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Address Line | 97 POINT OF WOODS DR
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City | PALM COAST
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State | FL
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Zip | 32164-6791
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Country | US
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Telephone | 515-371-5336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12481
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License Number State | FL
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