MEDICARE: MS. KARLA SUZANNE MILLER LISW

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	101YM0800X	Mental Health Counselor	06037	IA

General Provider Information

NPI Number	:	1427449107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KARLA SUZANNE MILLER LISW

Provider Business Mailing Address
First Line	:	332 S LINN ST
Second Line	:	SUITE 21
City	:	IOWA CITY
State	:	IA
Zip	:	52240-1608
Country	:	US
Telephone Number	:	319-330-8639
Fax Number	:	319-330-8639

Provider Business Practice Location Address
First Line	:	332 S LINN ST
Second Line	:	SUITE 21
City	:	IOWA CITY
State	:	IA
Zip	:	52240-1608
Country	:	US
Telephone Number	:	319-330-8639
Fax Number	:	319-330-8639

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

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

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