Provider Demographics
NPI:1225844327
Name:MILLER, STEPHANIE RHODES (MAC, LAC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RHODES
Last Name:MILLER
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 HARVEST BEND LN APT 14
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6154
Mailing Address - Country:US
Mailing Address - Phone:410-804-1765
Mailing Address - Fax:
Practice Address - Street 1:7350 GRACE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3386
Practice Address - Country:US
Practice Address - Phone:410-804-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03164171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist