Provider Demographics
NPI:1467723528
Name:MILLER, SANDRA LEE (LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005
Mailing Address - Country:US
Mailing Address - Phone:760-429-4434
Mailing Address - Fax:760-429-4434
Practice Address - Street 1:659 AVE. H
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005
Practice Address - Country:US
Practice Address - Phone:760-429-4434
Practice Address - Fax:760-429-4434
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker