Provider Demographics
NPI:1992466627
Name:MILLER, CHRISTY LYNN (MA)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16036 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3547
Mailing Address - Country:US
Mailing Address - Phone:720-495-1250
Mailing Address - Fax:
Practice Address - Street 1:6093 S QUEBEC ST STE 100
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4543
Practice Address - Country:US
Practice Address - Phone:720-504-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0110353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional