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General NPI Number Information
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NPI Number | 1154160935
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Entity Type | Individual
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Provider Name | CRYSTAL MILLER LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 9045 LA FONTANA BLVD
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City | BOCA RATON
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State | FL
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Zip | 33434-5636
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Country | US
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Telephone | 786-226-3179
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Fax |
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Provider Business Mailing Address
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Address Line | 12950 SW 187TH ST
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City | MIAMI
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State | FL
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Zip | 33177-3009
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Country | US
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Telephone | 786-226-3179
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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 | MH23666
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License Number State | FL
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