Provider Demographics
NPI:1013154152
Name:MILLER, SANDRA A (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:A
Other - Last Name:HUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:822 MARIETTA AVE
Mailing Address - Street 2:SUITE 31
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3239
Mailing Address - Country:US
Mailing Address - Phone:717-392-7062
Mailing Address - Fax:717-392-5495
Practice Address - Street 1:822 MARIETTA AVE
Practice Address - Street 2:SUITE 31
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3239
Practice Address - Country:US
Practice Address - Phone:717-392-7062
Practice Address - Fax:717-392-5495
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000567106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist