Provider Demographics
NPI:1851715429
Name:MILLER, ASHLEY (ACA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 N COLUMBIA ST
Mailing Address - Street 2:STE L
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2944
Mailing Address - Country:US
Mailing Address - Phone:985-590-5172
Mailing Address - Fax:985-249-2317
Practice Address - Street 1:434 N COLUMBIA ST
Practice Address - Street 2:STE L
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2944
Practice Address - Country:US
Practice Address - Phone:985-590-5172
Practice Address - Fax:985-249-2317
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAACA 200035171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist