Individual
FAWN GABRIELLE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, APCC
Contact information
Practice address
150 S 5TH ST STE 825, MINNEAPOLIS, MN 55402-4200
(877) 441-0121
Mailing address
PO BOX 1910, IDYLLWILD, CA 92549-1910
(915) 259-3810
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4537
CA
101YP2500X
Professional Counselor
9391
CA
106H00000X
Marriage & Family Therapist
Primary
116646
CA
106H00000X
Marriage & Family Therapist
1846
CO
Other
Enumeration date
10/20/2016
Last updated
05/07/2021
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