Provider Demographics
NPI:1336858737
Name:MILLER, MELODY
Entity Type:Individual
Prefix:
First Name:MELODY
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 1:8931 S YALE AVE STE U
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3531
Mailing Address - Country:US
Mailing Address - Phone:405-444-0013
Mailing Address - Fax:
Practice Address - Street 1:8931 S YALE AVE STE U
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3531
Practice Address - Country:US
Practice Address - Phone:405-444-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist