Doctor Name: | MRS. MICHELLE MILLER |
NPI Number: | 1144513979 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 083478 |
Business Practice Address: | 24302 Northern Blvd Douglaston, NY - 113621150 |
Business Phone Number: | 7184236200 |
Business Fax Number: | |
Mailing Address: | 20 Mariners Cv, EDGEWATER |
State: | NJ |
Postal Code: | 070201289 |
Phone Number: | 2018193231 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2011 |
NPI Last Update Date: | 05/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 083478 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |