Provider Demographics
NPI:1316232176
Name:MILLER, JOSHUA (LMFT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 BUNKER HILL ST.
Mailing Address - Street 2:SUITE D
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654
Mailing Address - Country:US
Mailing Address - Phone:907-357-8090
Mailing Address - Fax:907-357-8092
Practice Address - Street 1:601 BUNKER HILL ST.
Practice Address - Street 2:SUITE D
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-357-8090
Practice Address - Fax:907-357-8092
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist