Provider Demographics
NPI:1578619409
Name:MILLER, RENEE G (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:G
Last Name:MILLER
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 NW WALKER RD
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8140
Mailing Address - Country:US
Mailing Address - Phone:360-451-9253
Mailing Address - Fax:
Practice Address - Street 1:599 NW WALKER RD
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8140
Practice Address - Country:US
Practice Address - Phone:360-451-9253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60745030106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist