Provider Demographics
NPI:1346920956
Name:MILLER, LILLIAN DAWN
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:DAWN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 HUTCHINGS WAY
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-8318
Mailing Address - Country:US
Mailing Address - Phone:248-425-4345
Mailing Address - Fax:
Practice Address - Street 1:1100 W NEWARK RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-9449
Practice Address - Country:US
Practice Address - Phone:810-358-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst