Provider Demographics
NPI:1194977553
Name:MILLER, NETTIE P (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:NETTIE
Middle Name:P
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 MINDEN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-2907
Mailing Address - Country:US
Mailing Address - Phone:281-813-6391
Mailing Address - Fax:713-672-2990
Practice Address - Street 1:5424 MINDEN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-2907
Practice Address - Country:US
Practice Address - Phone:281-813-6391
Practice Address - Fax:713-672-2990
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17750101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151903501Medicaid
TX151903502Medicaid