Individual
LASSITER MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 W 25TH ST, BALTIMORE, MD 21218-5003
(410) 366-1717
(410) 889-4167
Mailing address
21 W 25TH ST, BALTIMORE, MD 21218-5003
(410) 366-1717
(410) 889-4167
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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