Provider Demographics
NPI:1851532352
Name:MILLER, JO CAROLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JO
Middle Name:CAROLYN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 DOUGLAS AVE STE 777
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5938
Mailing Address - Country:US
Mailing Address - Phone:214-691-0400
Mailing Address - Fax:214-691-7219
Practice Address - Street 1:8222 DOUGLAS AVE STE 777
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5938
Practice Address - Country:US
Practice Address - Phone:214-691-0400
Practice Address - Fax:214-691-7219
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350101YP2500X
TX1682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist