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Individual

MR. RONALD E MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
401 W CHICKASHA AVE, CHICKASHA, OK 73018-2503
(580) 504-2442
Mailing address
1715 STOUT RD, ARDMORE, OK 73401-1239
(580) 504-2442

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3602
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265713499
NPI
OK
Enumeration date
09/01/2011
Last updated
05/30/2012
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