Doctor Name: | TRACY LEE MILLER |
NPI Number: | 1184879728 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | SW12723 |
Business Practice Address: | 307 Boatner Rd Ste 114 Eglin Afb, FL - 325421302 |
Business Phone Number: | 9377070322 |
Business Fax Number: | |
Mailing Address: | 307 Boatner Rd Ste 114, EGLIN AFB |
State: | FL |
Postal Code: | 325421302 |
Phone Number: | 9377070322 |
Fax Number: | |
NPI Enumeration Date: | 11/24/2008 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW12723 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |