Individual
ANTONIO MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
11408 LAKE SHERWOOD AVE N, BATON ROUGE, LA 70816-0420
(225) 261-7143
(225) 250-1026
Mailing address
5635 MAIN ST # A183, ZACHARY, LA 70791-4083
(225) 335-5329
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
LA
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
01/29/2019
Last updated
09/11/2023
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