Provider Demographics
NPI:1356899314
Name:MILLER, DEANNE ELIZABETH (MH 17499)
Entity type:Individual
Prefix:MS
First Name:DEANNE
Middle Name:ELIZABETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:MH 17499
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:ELIZABETH
Other - Last Name:TORELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1908 HOWELL BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1009
Mailing Address - Country:US
Mailing Address - Phone:407-657-8555
Mailing Address - Fax:
Practice Address - Street 1:1908 HOWELL BRANCH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1009
Practice Address - Country:US
Practice Address - Phone:407-657-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X
FLMH17499101YM0800X
GALPC013856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty