Provider Demographics
NPI:1831827039
Name:MILLER, YVONNE
Entity type:Individual
Prefix:
First Name:YVONNE
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 1:19770 CLAY RD APT 9202
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3171
Mailing Address - Country:US
Mailing Address - Phone:708-368-5805
Mailing Address - Fax:
Practice Address - Street 1:1502 PARTNERSHIP WAY APT 7304
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5964
Practice Address - Country:US
Practice Address - Phone:708-368-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018200101YP2500X
TX92701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional