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General NPI Number Information
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NPI Number | 1104416171
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Entity Type | Individual
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Provider Name | CAROLYN MILLER LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 6930 CARROLL AVE STE 830
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4461
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Country | US
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Telephone | 301-563-9156
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Fax |
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Provider Business Mailing Address
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Address Line | 258 REBECCA ANN CT
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1032
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Country | US
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Telephone | 410-627-6804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 23961
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License Number State | MD
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