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General NPI Number Information
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NPI Number | 1568113181
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Entity Type | Individual
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Provider Name | CHANTEL MILLER MFT, PPS
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Gender | Female
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 901 S BROADWAY
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City | SANTA MARIA
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State | CA
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Zip | 93454-6603
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Country | US
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Telephone | 805-925-2567
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Fax |
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Provider Business Mailing Address
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Address Line | 791 PRICE ST # 124
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City | PISMO BEACH
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State | CA
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Zip | 93449-2529
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Country | US
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Telephone | 562-884-1631
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC41469
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License Number State | CA
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