Provider Demographics
NPI:1265784433
Name:MILLER, ALICISHA
Entity type:Individual
Prefix:MRS
First Name:ALICISHA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 JEANELL DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2113
Mailing Address - Country:US
Mailing Address - Phone:775-781-9723
Mailing Address - Fax:
Practice Address - Street 1:502 E JOHN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3099
Practice Address - Country:US
Practice Address - Phone:775-883-9800
Practice Address - Fax:775-883-9803
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor