Individual
CHELSIE LYNN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 820-3537
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.013600
IL
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178.013600
STATE LICENSE
IL
Enumeration date
09/06/2017
Last updated
11/14/2019
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