Provider Demographics
NPI:1710634688
Name:MILLER, ANNE (TLMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:TLMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 TANGLEFOOT LN
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1608
Mailing Address - Country:US
Mailing Address - Phone:563-396-2100
Mailing Address - Fax:
Practice Address - Street 1:770 TANGLEFOOT LN
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1608
Practice Address - Country:US
Practice Address - Phone:563-396-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110921101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor