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General NPI Number Information
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NPI Number | 1861531576
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Entity Type | Individual
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Provider Name | DEBRA MILLING LISW
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 444 ELMWOOD RD
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City | BAY VILLAGE
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State | OH
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Zip | 44140-2419
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Country | US
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Telephone | 304-972-1149
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Fax |
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Provider Business Mailing Address
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Address Line | 444 ELMWOOD RD
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City | BAY VILLAGE
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State | OH
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Zip | 44140-2419
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Country | US
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Telephone | 304-972-1149
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8764
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2102887
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | S116962
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License Number State | MA
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