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NPI Code Detail

MEDICARE: MISS HATTIE MILLER-RILEY MSW

MEDICARE: MISS HATTIE MILLER-RILEY MSW
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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16801001763OTHERMIMSW

General Provider Information

NPI Number : 1538380753
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS HATTIE MILLER-RILEY MSW
Provider Business Mailing Address
First Line : 11457 SHOEMAKER ST
Second Line :
City : DETROIT
State : MI
Zip : 48213-3418
Country : US
Telephone Number : 313-331-3435
Fax Number :
Provider Business Practice Location Address
First Line : 6309 MACK AVENUE
Second Line :
City : DETROIT
State : MI
Zip : 48207-2311
Country : US
Telephone Number : 313-921-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 06/13/2014

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Directions to “ MISS HATTIE MILLER-RILEY MSW” Practice Location

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