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Individual

BRANDON D MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PCC, LICDC

Contact information

Practice address
5211 MAHONING AVE STE 370, AUSTINTOWN, OH 44515-1853
(330) 792-4724
(330) 792-1848
Mailing address
2591 WILSON SHARPSVILLE RD, CORTLAND, OH 44410-9406

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
131009
OH
101YP2500X
Professional Counselor
Primary
E.1300036
OH

Other

Enumeration date
03/02/2016
Last updated
03/02/2016
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