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NPI Code Detail

MEDICARE: LAURIE MILLER LCSW

MEDICARE: LAURIE MILLER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker13419182-3502UT

General Provider Information

NPI Number : 1205397155
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE MILLER LCSW
Provider Business Mailing Address
First Line : 955 W 3300 S
Second Line :
City : SOUTH SALT LAKE
State : UT
Zip : 84119-3325
Country : US
Telephone Number : 801-646-8300
Fax Number :
Provider Business Practice Location Address
First Line : 955 W 3300 S
Second Line :
City : SOUTH SALT LAKE
State : UT
Zip : 84119-3325
Country : US
Telephone Number : 801-646-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2019
Last Update Date : 04/16/2026

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Directions to “ LAURIE MILLER LCSW” Practice Location

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