Basic Information
| Provider Information | |||||||||
| NPI: | 1821398553 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | JENNIFER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 421 W CANFIELD ST | ||||||||
| Address2: | ROOM 3217 | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482011219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3135777917 | ||||||||
| FaxNumber: | 3135777552 | ||||||||
| Practice Location | |||||||||
| Address1: | 4201 SAINT ANTOINE ST | ||||||||
| Address2: | UNIVERSITY HEALTH CENTER SUITE8A | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137454275 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2010 | ||||||||
| LastUpdateDate: | 10/28/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.