1336156793 NPI number — MRS. LEAH HAUSMAN MILLER M.A., PCC

Table of content: MRS. LEAH HAUSMAN MILLER M.A., PCC (NPI 1336156793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336156793 NPI number — MRS. LEAH HAUSMAN MILLER M.A., PCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
LEAH
Provider Middle Name:
HAUSMAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., PCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PETTIGREW
Provider Other First Name:
LEAH
Provider Other Middle Name:
HAUSMAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., PCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336156793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-248-0490
Provider Business Mailing Address Fax Number:
513-521-4856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-248-0490
Provider Business Practice Location Address Fax Number:
513-521-4856
Provider Enumeration Date:
08/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E0006602 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)