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Individual

ANN D MILLER-EDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC/MH

Contact information

Practice address
3705 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2817
(405) 367-1426
Mailing address
3705 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2817
(405) 367-1426

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1030
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200079250 A
OK
Enumeration date
04/23/2007
Last updated
04/24/2020
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