Provider Demographics
NPI:1871708461
Name:MILLER, NINA CUTLER (MFCT)
Entity type:Individual
Prefix:MS
First Name:NINA
Middle Name:CUTLER
Last Name:MILLER
Suffix:
Gender:F
Credentials:MFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1958
Mailing Address - Country:US
Mailing Address - Phone:909-229-9000
Mailing Address - Fax:888-291-2457
Practice Address - Street 1:2990 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-1958
Practice Address - Country:US
Practice Address - Phone:909-229-9000
Practice Address - Fax:888-291-2457
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 12814106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist