Provider Demographics
NPI:1669031415
Name:MILLER, DENEEN MICHELLE
Entity Type:Individual
Prefix:
First Name:DENEEN
Middle Name:MICHELLE
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 1:4660 MARTIN LUTHER KING JR AVE SW APT B605
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4980
Mailing Address - Country:US
Mailing Address - Phone:202-487-6398
Mailing Address - Fax:
Practice Address - Street 1:606 GALVESTON PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3540
Practice Address - Country:US
Practice Address - Phone:301-802-4176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor