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Individual

MR. MARK JOHN MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC LADAC

Contact information

Practice address
1800 S LOCUST ST, LAS CRUCES, NM 88001
(575) 522-6944
(575) 522-7901
Mailing address
1800 S LOCUST ST, LAS CRUCES, NM 88001
(575) 522-6944
(575) 522-7901

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
005708
NM
101YP2500X
Professional Counselor
Primary
0076621
NM

Other

Enumeration date
11/16/2006
Last updated
07/16/2010
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