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General NPI Number Information
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NPI Number | 1568594612
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Entity Type | Individual
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Provider Name | KATHRYN EMILY MILLER MSW
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 2520 EASTERN AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49507-3633
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Country | US
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Telephone | 616-243-1822
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Fax | 616-243-2069
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Provider Business Mailing Address
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Address Line | 5064 SHINNECOCK HILLS DR NW
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City | COMSTOCK PARK
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State | MI
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Zip | 49321-9344
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Country | US
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Telephone | 616-450-5730
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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 | 6801088787
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License Number State | MI
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