Individual
JODI ELAINE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 SERENITY LN, COBURG, OR 97408-9350
(541) 743-5969
Mailing address
5236 MAIN ST APT 17, SPRINGFIELD, OR 97478-6268
(541) 743-5969
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-2048
OR
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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