Individual
MR. JONATHAN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, PLPC
Contact information
Practice address
18614 WHISKEY CREEK RD, WILDWOOD, MO 63069-2530
(314) 504-3828
Mailing address
PO BOX 220081, SAINT LOUIS, MO 63122-0081
(314) 504-3828
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2008037618
MO
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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