Provider Demographics
NPI:1568466415
Name:MILLER, LAURA M (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:58620 SINK RD
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-9766
Mailing Address - Country:US
Mailing Address - Phone:269-782-4141
Mailing Address - Fax:269-782-0248
Practice Address - Street 1:58620 SINK RD.
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-9766
Practice Address - Country:US
Practice Address - Phone:269-782-4141
Practice Address - Fax:269-782-0248
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010576201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical