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General NPI Number Information
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NPI Number | 1568942985
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Entity Type | Individual
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Provider Name | CHARLES FRANKLIN MILLER ASW
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Gender | Male
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 916 N WESTERN AVE STE 210
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City | SAN PEDRO
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State | CA
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Zip | 90732-2407
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Country | US
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Telephone | 866-519-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 2681 SKYLINE DR
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City | SIGNAL HILL
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State | CA
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Zip | 90755-3822
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Country | US
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Telephone | 562-417-1017
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW76376
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License Number State | CA
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