Provider Demographics
NPI:1922232057
Name:MILLER, JULIE NADINE (CMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:NADINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JACKSON ST STE 103B
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7171
Mailing Address - Country:US
Mailing Address - Phone:408-646-6373
Mailing Address - Fax:
Practice Address - Street 1:10 JACKSON ST
Practice Address - Street 2:103B
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7141
Practice Address - Country:US
Practice Address - Phone:408-646-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33729175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath