Individual
JONATHAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
315 5TH AVE, FAIRBANKS, AK 99701-5025
(907) 374-7776
Mailing address
315 5TH AVE, FAIRBANKS, AK 99701-5025
(907) 374-7776
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
873
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1596091
—
AK
Enumeration date
09/19/2013
Last updated
05/01/2015
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