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General NPI Number Information
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NPI Number | 1508633116
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Entity Type | Individual
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Provider Name | LAUREN MICHELLE MILLER CDCA
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Gender | Female
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 430 N BROADWAY ST
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City | GREEN SPRINGS
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State | OH
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Zip | 44836-9734
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Country | US
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Telephone | 419-217-9762
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Fax | 567-686-1412
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Provider Business Mailing Address
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Address Line | 479 MARION AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2050
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Country | US
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Telephone | 419-544-8560
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Fax | 567-686-1412
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 186521
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License Number State | OH
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