Provider Demographics
NPI:1043426448
Name:MILLER, JOHANNA ERIN (MA, PCC)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:ERIN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 OAK DR NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5327
Mailing Address - Country:US
Mailing Address - Phone:330-966-0362
Mailing Address - Fax:
Practice Address - Street 1:3593 S ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5271
Practice Address - Country:US
Practice Address - Phone:330-417-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0004191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health