Provider Demographics
NPI:1881215242
Name:MILLER, JAMIE TERESA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:TERESA
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STATES AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-1127
Mailing Address - Country:US
Mailing Address - Phone:609-510-8738
Mailing Address - Fax:
Practice Address - Street 1:9 TANNER ST STE 103
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2432
Practice Address - Country:US
Practice Address - Phone:609-510-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty