Provider Demographics
NPI:1649923566
Name:MILLER, JOI (LLPC, MSP, TRS)
Entity type:Individual
Prefix:
First Name:JOI
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LLPC, MSP, TRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33475 BIRCHLAWN
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-8905
Mailing Address - Country:US
Mailing Address - Phone:313-461-6383
Mailing Address - Fax:
Practice Address - Street 1:496 W ANN ARBOR TRL STE 202
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6262
Practice Address - Country:US
Practice Address - Phone:313-591-8417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty