Provider Demographics
NPI:1104369545
Name:MILLER, ROSEMARIE (LAADC)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1320
Mailing Address - Country:US
Mailing Address - Phone:951-850-2376
Mailing Address - Fax:
Practice Address - Street 1:437 SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1320
Practice Address - Country:US
Practice Address - Phone:951-850-2376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor