| Mindy Miller Llc | |
|
1505 E 20th St Joplin MO 64804-0928 | |
| (417) 627-9601 | |
| (417) 627-9032 |
| Full Name | Mindy Miller Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1505 E 20th St, Joplin, Missouri |
| Authorized Official Name and Position | Mindy J Miller (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4176279601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindy Miller Llc 1505 E 20th St Joplin MO 64804-0928 Ph: (417) 627-9601 | Mindy Miller Llc 1505 E 20th St Joplin MO 64804-0928 Ph: (417) 627-9601 |
| NPI Number | 1699947820 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 03/27/2008 |
| Medicare PECOS PAC ID | 5597843615 |
|---|---|
| Medicare Enrollment ID | O20080415000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699947820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mindy J Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104902220 PECOS PAC ID: 6103859582 Enrollment ID: I20050915000839 |
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