Provider Demographics
NPI:1578619144
Name:MILLER, HEATHER JOYCE (QMHA)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:JOYCE
Last Name:MILLER
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4834 LIBERTY RD S
Mailing Address - Street 2:57
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2440
Mailing Address - Country:US
Mailing Address - Phone:503-559-2550
Mailing Address - Fax:
Practice Address - Street 1:499 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2505
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No372600000XNursing Service Related ProvidersAdult Companion