Provider Demographics
NPI:1811021082
Name:MILLER, LOIS ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 EAST DAVIS BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606
Mailing Address - Country:US
Mailing Address - Phone:813-258-3906
Mailing Address - Fax:813-258-9622
Practice Address - Street 1:238 EAST DAVIS BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-258-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00017381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical