Individual
REBECCA JO MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1032 S BRIDGEWAY PL, EAGLE, ID 83616-6099
(208) 246-0123
(208) 246-0125
Mailing address
2608 S COLUMBUS ST, BOISE, ID 83705-4340
(208) 866-4628
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7210
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LPC-7210
—
ID
Enumeration date
03/05/2019
Last updated
03/05/2019
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