Provider Demographics
NPI:1174870216
Name:MILLER, HEATHER LEA HOLLISTER (MS)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LEA HOLLISTER
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32447-0058
Mailing Address - Country:US
Mailing Address - Phone:850-676-4012
Mailing Address - Fax:850-248-2469
Practice Address - Street 1:1346 N RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-1566
Practice Address - Country:US
Practice Address - Phone:850-676-4012
Practice Address - Fax:850-248-2469
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health