Provider Demographics
NPI:1063283406
Name:MILLER, CHRISTIAN MICHAEL
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 AUTUMN HILL TRL
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9463
Mailing Address - Country:US
Mailing Address - Phone:812-525-7521
Mailing Address - Fax:
Practice Address - Street 1:2420 E 10TH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-6000
Practice Address - Country:US
Practice Address - Phone:812-282-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health