Provider Demographics
NPI:1730290008
Name:MILLER, TAMMY DEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:DEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-6404
Mailing Address - Country:US
Mailing Address - Phone:817-641-0098
Mailing Address - Fax:817-255-7166
Practice Address - Street 1:4500 S LANCASTER RD # 116A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:817-255-7146
Practice Address - Fax:817-255-7166
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34021104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker