Provider Demographics
NPI:1306344056
Name:MILLER, NAVAUDA SHAREE (LPC)
Entity type:Individual
Prefix:
First Name:NAVAUDA
Middle Name:SHAREE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 N PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76367-1331
Mailing Address - Country:US
Mailing Address - Phone:940-886-7873
Mailing Address - Fax:
Practice Address - Street 1:1215 N PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-1331
Practice Address - Country:US
Practice Address - Phone:940-886-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional