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Individual

BRANDON SCOTT MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
213 BROADMORE ST, ENTERPRISE, OR 97828-1216
(541) 398-8188
Mailing address
PO BOX 268, ENTERPRISE, OR 97828-0268

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22-06-10445
OR
101YM0800X
Mental Health Counselor
Primary
L11633
OR

Other

Enumeration date
10/17/2018
Last updated
01/15/2024
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