Individual
SHANTE MONIQUE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO 61037377
Contact information
Practice address
2601 SUMMIT AVE, EVERETT, WA 98201-3309
(425) 258-2407
(425) 339-2601
Mailing address
500 E FREMONT ST APT B103, MONROE, WA 98272-2364
(504) 417-6938
(206) 223-1482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO61037377
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61037377
WA
Other
Enumeration date
04/14/2020
Last updated
06/21/2021
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