Provider Demographics
NPI:1033473095
Name:MILLER, EVA (MPS, ATR, LPC)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MPS, ATR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 SAGAMORE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4743
Mailing Address - Country:US
Mailing Address - Phone:919-306-3650
Mailing Address - Fax:
Practice Address - Street 1:14 GLENWOOD AVE
Practice Address - Street 2:STUDIO 18A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1700
Practice Address - Country:US
Practice Address - Phone:919-306-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional