Provider Demographics
NPI:1437462876
Name:MILLER, TENECIA A (MED)
Entity Type:Individual
Prefix:
First Name:TENECIA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 SW 22ND ST APT 1605
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1936
Mailing Address - Country:US
Mailing Address - Phone:580-421-5861
Mailing Address - Fax:
Practice Address - Street 1:4317 SW 22ND ST APT 1605
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1936
Practice Address - Country:US
Practice Address - Phone:580-421-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health