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General NPI Number Information
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NPI Number | 1508849159
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Entity Type | Individual
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Provider Name | MINDY SUE MILLER MSW CSW
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Gender | Female
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 10/23/2022
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Provider Practice Location Address
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Address Line | 148 W WASHINGTON ST STE A
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City | MARQUETTE
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State | MI
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Zip | 49855-4383
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Country | US
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Telephone | 906-273-2507
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Fax | 906-273-2507
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Provider Business Mailing Address
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Address Line | 307 S FRONT ST STE 115
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City | MARQUETTE
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State | MI
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Zip | 49855-4610
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Country | US
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Telephone | 906-273-2507
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Fax | 906-273-2507
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801071650
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License Number State | MI
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