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General NPI Number Information
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NPI Number | 1972204808
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Entity Type | Individual
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Provider Name | OLIVIA MILLER LP-MHC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 7 CLAYTON AVE
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City | CORTLAND
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State | NY
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Zip | 13045-2501
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Country | US
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Telephone | 607-758-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 403 OAK ST APT 1
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City | SYRACUSE
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State | NY
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Zip | 13203-2956
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Country | US
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Telephone | 267-885-8932
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P120245
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License Number State | NY
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