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General NPI Number Information
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NPI Number | 1609695568
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Entity Type | Individual
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Provider Name | MS. JENNIFER MARY MILLER
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 650 EAST AVE
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City | ERIE
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State | PA
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Zip | 16503-1524
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Country | US
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Telephone | 814-455-5505
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Fax | 814-455-5515
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Provider Business Mailing Address
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Address Line | 100 SHENANGO AVE
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City | SHARON
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State | PA
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Zip | 16146-2102
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Country | US
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Telephone | 814-455-5505
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Fax | 814-455-5515
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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 | PC017610
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC017610
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License Number State | PA
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