Provider Demographics
NPI:1538502125
Name:MILLER, JONNA L
Entity Type:Individual
Prefix:MS
First Name:JONNA
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 CENTRAL ST
Mailing Address - Street 2:APT 10
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-2743
Mailing Address - Country:US
Mailing Address - Phone:518-859-4957
Mailing Address - Fax:
Practice Address - Street 1:555 ARMORY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2652
Practice Address - Country:US
Practice Address - Phone:617-522-0900
Practice Address - Fax:617-522-0904
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor