Provider Demographics
NPI:1598477812
Name:MILLER, OLIVIA SHARON
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:SHARON
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 1:610 JASMINE COVE CIR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7177
Mailing Address - Country:US
Mailing Address - Phone:864-247-7805
Mailing Address - Fax:
Practice Address - Street 1:610 JASMINE COVE CIR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7177
Practice Address - Country:US
Practice Address - Phone:864-247-7805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical