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General NPI Number Information
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NPI Number | 1386085074
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Entity Type | Individual
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Provider Name | CHARITY ANGELICA MILLER M.S. LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 4164 BROCKTON AVE STE A
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City | RIVERSIDE
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State | CA
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Zip | 92501-3400
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Country | US
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Telephone | 951-888-1346
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Fax |
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Provider Business Mailing Address
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Address Line | 27692 CALLANDER ST
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City | MORENO VALLEY
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State | CA
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Zip | 92555-5902
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Country | US
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Telephone | 951-616-0326
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 80440
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 101011
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License Number State | CA
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