Individual
CANDISE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 BETHESDA PL, WINSTON SALEM, NC 27103-3331
(255) 751-0518
Mailing address
3851 DUNHAGAN RD STE 102, GREENVILLE, NC 27858-6640
(252) 751-0518
(252) 565-4505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-19-2019
NC
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/06/2017
Last updated
06/19/2019
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