MEDICARE: CORRINE MILLER LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	S.1600761	OH

General Provider Information

NPI Number	:	1255822862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRINE MILLER LSW

Provider Business Mailing Address
First Line	:	5385 PINEVALLEY DR
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1869
Country	:	US
Telephone Number	:	513-804-4192
Fax Number	:

Provider Business Practice Location Address
First Line	:	5234 W ST RT 63
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-8202
Country	:	US
Telephone Number	:	513-933-9304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2018
Last Update Date	:	05/21/2018

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Directions to “ CORRINE MILLER LSW” Practice Location

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