Provider Demographics
NPI:1730397902
Name:MILLER, LEE STERN (MFT)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:STERN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2917
Mailing Address - Country:US
Mailing Address - Phone:215-635-3589
Mailing Address - Fax:
Practice Address - Street 1:7807 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2917
Practice Address - Country:US
Practice Address - Phone:215-635-3589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist