MEDICARE: DR. NETTIE P. MILLER PHD, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	17750	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194977553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NETTIE P. MILLER PHD, LPC

Provider Business Mailing Address
First Line	:	5424 MINDEN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77026-2907
Country	:	US
Telephone Number	:	281-813-6391
Fax Number	:	713-672-2990

Provider Business Practice Location Address
First Line	:	5424 MINDEN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77026-2907
Country	:	US
Telephone Number	:	281-813-6391
Fax Number	:	713-672-2990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	10/16/2008

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