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General NPI Number Information
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NPI Number | 1689480154
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Entity Type | Individual
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Provider Name | SAMANTHA NICOLE MILLER
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Gender | Female
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 66 E MAIN ST STE 300H
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City | WESTMINSTER
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State | MD
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Zip | 21157-2709
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Country | US
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Telephone | 443-241-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 OLD ANNAPOLIS RD
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City | WOODBINE
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State | MD
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Zip | 21797-8201
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Country | US
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Telephone | 443-463-3175
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP15927
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License Number State | MD
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