Provider Demographics
NPI:1730398231
Name:MILLER, JOY (MRC, CRC, PC)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MRC, CRC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 S CONANT RD
Mailing Address - Street 2:
Mailing Address - City:SPENCERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45887-9713
Mailing Address - Country:US
Mailing Address - Phone:419-647-4203
Mailing Address - Fax:419-647-6820
Practice Address - Street 1:3356 S CONANT RD
Practice Address - Street 2:
Practice Address - City:SPENCERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45887-9713
Practice Address - Country:US
Practice Address - Phone:419-647-4203
Practice Address - Fax:419-647-6820
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0007669101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor