Provider Demographics
NPI:1215266721
Name:MILLER, DEBRA ANN
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LYNWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-4731
Mailing Address - Country:US
Mailing Address - Phone:603-352-0793
Mailing Address - Fax:603-352-2066
Practice Address - Street 1:25 ROXBURY ST
Practice Address - Street 2:HANNAH GRIMES-PLAN B
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3257
Practice Address - Country:US
Practice Address - Phone:603-352-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral