Provider Demographics
NPI:1063522068
Name:MILLER, JANE H (MSSA LISW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:H
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSSA LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 GLENHURST DRIVE
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074
Mailing Address - Country:US
Mailing Address - Phone:800-457-0345
Mailing Address - Fax:
Practice Address - Street 1:7 NORTH MAIN ST
Practice Address - Street 2:SUITE 121
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074
Practice Address - Country:US
Practice Address - Phone:800-457-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHL0008748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health