Provider Demographics
NPI:1952371197
Name:MILLER, M GRAYSON (LPC)
Entity type:Individual
Prefix:
First Name:M
Middle Name:GRAYSON
Last Name:MILLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 SAN FELIPE STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1630
Mailing Address - Country:US
Mailing Address - Phone:713-785-1500
Mailing Address - Fax:713-785-1512
Practice Address - Street 1:7700 SAN FELIPE ST
Practice Address - Street 2:SUITE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1630
Practice Address - Country:US
Practice Address - Phone:713-785-1500
Practice Address - Fax:713-785-1512
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional