Provider Demographics
NPI:1932862372
Name:MILLER, CURTIS DAMON I
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:DAMON
Last Name:MILLER
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W. SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613
Mailing Address - Country:US
Mailing Address - Phone:567-315-4524
Mailing Address - Fax:
Practice Address - Street 1:1701 W SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613
Practice Address - Country:US
Practice Address - Phone:216-208-0634
Practice Address - Fax:419-214-0506
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)