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NPI Code Detail

MEDICARE: MELISSA KAY MILLER LMSW

MEDICARE:   MELISSA KAY MILLER  LMSW
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
1104100000XSocial Worker60979TX

General Provider Information

NPI Number : 1871001651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA KAY MILLER LMSW
Provider Business Mailing Address
First Line : 1300 W ROSEDALE ST STE 8
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2826
Country : US
Telephone Number : 817-377-4011
Fax Number :
Provider Business Practice Location Address
First Line : 1300 W ROSEDALE ST STE 8
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2826
Country : US
Telephone Number : 817-377-4011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2018
Last Update Date : 01/16/2018

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Directions to “ MELISSA KAY MILLER LMSW” Practice Location

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