Basic Information
| Provider Information | |||||||||
| NPI: | 1407043623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | TRISHA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | P.C.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1781 ROLLING HILLS DR APT C | ||||||||
| Address2: | |||||||||
| City: | TWINSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440871046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2164036577 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2803 AKRON RD | ||||||||
| Address2: | |||||||||
| City: | WOOSTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446917904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302643232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2007 | ||||||||
| LastUpdateDate: | 10/02/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | E0008355 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.