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General NPI Number Information
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NPI Number | 1568547131
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Entity Type | Individual
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Provider Name | BRIAN JOHN MILLER LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1180 PROFESSIONAL CT
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5852
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Country | US
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Telephone | 301-791-3045
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Fax | 240-313-3071
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Provider Business Mailing Address
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Address Line | 20539 BLUEBIRD AVE
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City | HAGERSTOWN
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State | MD
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Zip | 21742-4423
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Country | US
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Telephone | 301-791-3850
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 06291
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License Number State | MD
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