MEDICARE: ALAINA M PARDEE-MILLER LISW-S

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
1	104100000X	Social Worker	I.1201380	OH

General Provider Information

NPI Number	:	1659616704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAINA M PARDEE-MILLER LISW-S

Provider Business Mailing Address
First Line	:	1212 HURON RD E
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1715
Country	:	US
Telephone Number	:	216-619-6194
Fax Number	:	216-619-6195

Provider Business Practice Location Address
First Line	:	1212 HURON RD E
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1715
Country	:	US
Telephone Number	:	216-619-6194
Fax Number	:	216-619-6195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	03/06/2017

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