Provider Demographics
NPI:1043781511
Name:MILLER, MEAGAN ALICE
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:ALICE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 GENESEE RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95983-9735
Mailing Address - Country:US
Mailing Address - Phone:805-423-7891
Mailing Address - Fax:
Practice Address - Street 1:2167 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4945
Practice Address - Country:US
Practice Address - Phone:530-538-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty