Provider Demographics
NPI:1417043357
Name:MILLER, NICOLE E (MA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:E
Other - Last Name:WOODRUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1258 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1258 HIGH ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3238
Practice Address - Country:US
Practice Address - Phone:541-342-8437
Practice Address - Fax:541-342-1639
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health