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General NPI Number Information
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NPI Number | 1063724631
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Entity Type | Organization
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Legal Business Name | SUSAN J. MILLER, PLLC
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 110 RICHIE LN SUITE C
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City | SOMERSET
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State | KY
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Zip | 42503-6128
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Country | US
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Telephone | 606-305-3791
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Fax | 606-678-0603
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Provider Business Mailing Address
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Address Line | 110 RICHIE LN SUITE C
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City | SOMERSET
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State | KY
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Zip | 42503-6128
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Country | US
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Telephone | 606-305-3791
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Fax | 606-678-0603
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN J MILLER
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Credential | L.C.S.W.
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Telephone | 606-305-3791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1105
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License Number State | KY
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