Provider Demographics
NPI:1861845364
Name:MILLER, NANCY LOUISE (MS, PC, NCC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LOUISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, PC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 EAST AVENUE SOUTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601
Mailing Address - Country:US
Mailing Address - Phone:608-790-9481
Mailing Address - Fax:608-790-9480
Practice Address - Street 1:2920 EAST AVENUE SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601
Practice Address - Country:US
Practice Address - Phone:608-790-9481
Practice Address - Fax:608-790-9480
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional