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General NPI Number Information
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NPI Number | 1821460619
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Entity Type | Individual
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Provider Name | DONNA JANE WOMACK-MILLER MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 803 STAMPER RD STE G
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4193
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Country | US
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Telephone | 910-223-7114
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Fax | 910-550-3803
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Provider Business Mailing Address
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Address Line | 1023 FAIRFIELD CIR
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City | RAEFORD
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State | NC
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Zip | 28376-6607
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Country | US
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Telephone | 910-550-3803
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Fax | 407-479-3846
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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 | C006107
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License Number State | NC
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