Provider Demographics
NPI:1114316304
Name:MILLER, SHEILA DAWN (BS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:DAWN
Last Name:MILLER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 MILLIGAN HWY
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-5520
Mailing Address - Country:US
Mailing Address - Phone:423-943-0424
Mailing Address - Fax:
Practice Address - Street 1:2700 S ROAN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-7556
Practice Address - Country:US
Practice Address - Phone:423-232-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker