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General NPI Number Information
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NPI Number | 1821109125
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Entity Type | Individual
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Provider Name | VIVIAN LEANNA JENNINGS-MILLER PHD, LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 957 NASA PKWY # 1047
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City | HOUSTON
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State | TX
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Zip | 77058-3039
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Country | US
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Telephone | 281-819-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 957 NASA PKWY # 1047
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City | HOUSTON
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State | TX
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Zip | 77058-3039
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Country | US
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Telephone | 281-819-0398
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 40082
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License Number State | TX
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