Provider Demographics
NPI:1144736687
Name:MILLER, WANDA JEAN (MSW)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5448
Mailing Address - Country:US
Mailing Address - Phone:302-292-1334
Mailing Address - Fax:
Practice Address - Street 1:262 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5448
Practice Address - Country:US
Practice Address - Phone:302-292-1334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker