Provider Demographics
NPI:1407043623
Name:MILLER, TRISHA LYNN (PCC)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 ROLLING HILLS DR APT C
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1046
Mailing Address - Country:US
Mailing Address - Phone:216-403-6577
Mailing Address - Fax:
Practice Address - Street 1:2803 AKRON RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7904
Practice Address - Country:US
Practice Address - Phone:330-264-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008355101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health