Provider Demographics
NPI:1285471912
Name:MILLER, TEENA (LAMFT)
Entity type:Individual
Prefix:
First Name:TEENA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4873 E FIRESTONE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-7392
Mailing Address - Country:US
Mailing Address - Phone:313-475-8636
Mailing Address - Fax:
Practice Address - Street 1:4873 E FIRESTONE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-7392
Practice Address - Country:US
Practice Address - Phone:313-475-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-08052T106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist