Provider Demographics
NPI:1497182950
Name:MILLER, ALLISON NICOLE (MCP, LPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MCP, LPC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NICOLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCP, LPC
Mailing Address - Street 1:609 E HARTFORD AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-2006
Mailing Address - Country:US
Mailing Address - Phone:580-765-0030
Mailing Address - Fax:580-765-0073
Practice Address - Street 1:609 E HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2006
Practice Address - Country:US
Practice Address - Phone:580-765-0030
Practice Address - Fax:580-765-0073
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional