Provider Demographics
NPI:1083853709
Name:MILLER, JENNIFER LYNNE (MA, RN, LMHC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, RN, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 W 2ND AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-4539
Mailing Address - Country:US
Mailing Address - Phone:509-458-5889
Mailing Address - Fax:509-624-1216
Practice Address - Street 1:906 W 2ND AVE STE 600
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4539
Practice Address - Country:US
Practice Address - Phone:509-458-5889
Practice Address - Fax:509-624-1216
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60069317101YM0800X
WARN00097765163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health