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General NPI Number Information
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NPI Number | 1922205962
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Entity Type | Individual
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Provider Name | MARSHA THOMAS MILLER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 199 CHARMANT DRIVE SUITE 2
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City | RIDGELAND
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State | MS
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Zip | 39157
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Country | US
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Telephone | 601-605-4084
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Fax | 601-605-4085
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Provider Business Mailing Address
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Address Line | 456 MOCKINGBIRD LN
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City | MADISON
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State | MS
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Zip | 39110-9575
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Country | US
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Telephone | 601-853-7851
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Fax | 601-605-4085
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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 | 0909
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License Number State | MS
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