Provider Demographics
NPI:1710669619
Name:MILLER, ANGEL M (QMHA)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BEATTY ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-5811
Mailing Address - Country:US
Mailing Address - Phone:541-450-7024
Mailing Address - Fax:541-414-0750
Practice Address - Street 1:200 BEATTY ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5811
Practice Address - Country:US
Practice Address - Phone:541-450-7024
Practice Address - Fax:541-414-0750
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist