Provider Demographics
NPI:1689972119
Name:MILLER, ABBE (MS, ATR-BC, LPC)
Entity Type:Individual
Prefix:MS
First Name:ABBE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-0021
Mailing Address - Country:US
Mailing Address - Phone:860-657-4061
Mailing Address - Fax:
Practice Address - Street 1:891 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073
Practice Address - Country:US
Practice Address - Phone:860-657-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health