Provider Demographics
NPI:1376778423
Name:MILLER, DEBRA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3611 N SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2384
Mailing Address - Country:US
Mailing Address - Phone:989-631-2320
Mailing Address - Fax:
Practice Address - Street 1:3611 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2384
Practice Address - Country:US
Practice Address - Phone:989-631-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010862061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical