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Individual

MRS. DAPHNE MILLER DETIEGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
908 N 3RD ST, MONROE, LA 71201-5844
(318) 325-8748
(318) 325-8749
Mailing address
908 N 3RD ST, MONROE, LA 71201-5844
(318) 325-8748
(318) 325-8749

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AN543770
DEPARTMENT OF EDUCATION
LA
Enumeration date
10/01/2015
Last updated
01/13/2020
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