Provider Demographics
NPI:1023763034
Name:MILLER, ANNA IRENE (QMHS &3)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:IRENE
Last Name:MILLER
Suffix:
Gender:F
Credentials:QMHS &3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 ST. RT 60
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-8707
Mailing Address - Country:US
Mailing Address - Phone:419-289-4825
Mailing Address - Fax:419-289-4826
Practice Address - Street 1:1763 ST. RT 60
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-8707
Practice Address - Country:US
Practice Address - Phone:419-289-4825
Practice Address - Fax:419-289-4826
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator