MEDICARE: PATRICIA MILLER

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	101YM0800X	Mental Health Counselor	319393-6009	UT

General Provider Information

NPI Number	:	1659795201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MILLER

Provider Business Mailing Address
First Line	:	2937 S MELBOURNE ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4064
Country	:	US
Telephone Number	:	801-859-6130
Fax Number	:

Provider Business Practice Location Address
First Line	:	2937 S MELBOURNE ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4064
Country	:	US
Telephone Number	:	801-859-6130
Fax Number	:

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

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	02/20/2026

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