Provider Demographics
NPI:1679939599
Name:MILLER, KIEREA CHANELLE (AMFT)
Entity type:Individual
Prefix:
First Name:KIEREA
Middle Name:CHANELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 W 250 S UNIT D203
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-5518
Mailing Address - Country:US
Mailing Address - Phone:509-388-4319
Mailing Address - Fax:801-491-3911
Practice Address - Street 1:763 N 1650 W
Practice Address - Street 2:SPRINGVILLE
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-5066
Practice Address - Country:US
Practice Address - Phone:801-704-1364
Practice Address - Fax:801-491-3911
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9086704-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist