MEDICARE: PAULA MILLER 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	66279	TX

General Provider Information

NPI Number	:	1215345640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA MILLER LPC

Provider Business Mailing Address
First Line	:	3328 MIRO PL
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-7526
Country	:	US
Telephone Number	:	214-784-8134
Fax Number	:

Provider Business Practice Location Address
First Line	:	10100 N CENTRAL EXPY
Second Line	:	SUITE 275
City	:	DALLAS
State	:	TX
Zip	:	75231-4159
Country	:	US
Telephone Number	:	214-784-8134
Fax Number	:

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

Provider Enumeration Date	:	07/29/2014
Last Update Date	:	11/07/2016

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