Miller, Liesal Marie

Miller, Liesal Marie is an individual health care provider with primary practice located at 205 S Ballard Ave , Wylie TX 75098-3640. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Miller, Liesal Marie can be contacted via phone (469) 757-4525.

Contact Information

Primary practice address
205 S Ballard Ave Wylie TX 75098-3640
Phone: (469) 757-4525
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 202138 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 49391 California

Profile Details

NPI number 1285778852
LBN Legal business name Miller, Liesal Marie
Credentials Marriage and Family Therapist (MFT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2007
Last updated May 20th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285778852 NPPES
California Other 49391 CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
California Other 202138 CALIFORNIA BOARD OF BEHAVIORAL SCIENCES

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