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Individual
MR. MARK JAY MILLER
Active
Individual
MR. MARK JAY MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
L002041
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
L002041
OR
101YP2500X
Professional Counselor
L002041
OR
1041C0700X
Clinical Social Worker
Primary
L002041
OR
106H00000X
Marriage & Family Therapist
L002041
OR
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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