Doctor Name: | SUSAN LUCY MILLER |
NPI Number: | 1558517169 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 329431 |
Business Practice Address: | 729 San Diego Loop Jemez Springs, NM - 87025 |
Business Phone Number: | 5758294526 |
Business Fax Number: | |
Mailing Address: | 729 San Diego Loop, JEMEZ SPRINGS |
State: | NM |
Postal Code: | 87025 |
Phone Number: | 5758294526 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2008 |
NPI Last Update Date: | 08/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 329431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |