Provider Demographics
NPI:1083740716
Name:MILLER, KIMRI LUCILLE (MA,CRC)
Entity Type:Individual
Prefix:MS
First Name:KIMRI
Middle Name:LUCILLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA,CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-2660
Mailing Address - Country:US
Mailing Address - Phone:985-876-8879
Mailing Address - Fax:985-873-2013
Practice Address - Street 1:6907 ALMA ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-2660
Practice Address - Country:US
Practice Address - Phone:985-876-8879
Practice Address - Fax:985-873-2013
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health