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General NPI Number Information
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NPI Number | 1982339685
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Entity Type | Individual
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Provider Name | MILLER FAW
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Gender | Male
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | MILES ANNAS STUDENT SERVICES BUILDING
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City | BOONE
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State | NC
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Zip | 28608-0001
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Country | US
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Telephone | 828-262-3148
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Fax | 828-262-8452
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Provider Business Mailing Address
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Address Line | 152 CHASE HILL DR
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City | BOONE
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State | NC
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Zip | 28607-7913
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Country | US
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Telephone | 336-339-7893
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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 |
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License Number State |
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