Provider Demographics
NPI:1366987562
Name:MILLER, ELIZABETH LEIGH (M ED COUNSELING)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:M ED COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3317 APPALACHIAN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0159
Mailing Address - Country:US
Mailing Address - Phone:573-673-1758
Mailing Address - Fax:
Practice Address - Street 1:3317 APPALACHIAN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-0159
Practice Address - Country:US
Practice Address - Phone:736-731-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-23
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017009206101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional