Provider Demographics
NPI:1871277624
Name:MILLER, LEANNE (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13323 W WASHINGTON BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5164
Mailing Address - Country:US
Mailing Address - Phone:310-469-1415
Mailing Address - Fax:
Practice Address - Street 1:13323 W WASHINGTON BLVD STE 207
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5164
Practice Address - Country:US
Practice Address - Phone:310-469-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist