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Individual
TERRY E MILLER
Active
Individual
TERRY E MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC2879
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010018335
REGENCE BLUE SHIELD OF ID
ID
01
—
Q4772
BLUE CROSS OF IDAHO
ID
Enumeration date
08/22/2007
Last updated
08/22/2007
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