Provider Demographics
NPI:1225539844
Name:MILLER, TONYA MICHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3529
Mailing Address - Country:US
Mailing Address - Phone:419-999-2010
Mailing Address - Fax:419-999-6284
Practice Address - Street 1:25 CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-3318
Practice Address - Country:US
Practice Address - Phone:419-435-8112
Practice Address - Fax:419-435-6220
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700488101Y00000X
OHE.2203009101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor