Provider Demographics
NPI:1255822862
Name:MILLER, CORRINE (LSW)
Entity type:Individual
Prefix:
First Name:CORRINE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CORRINE
Other - Middle Name:
Other - Last Name:SCHIAVONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:5385 PINEVALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1869
Mailing Address - Country:US
Mailing Address - Phone:513-804-4192
Mailing Address - Fax:
Practice Address - Street 1:5234 W ST RT 63
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8202
Practice Address - Country:US
Practice Address - Phone:513-933-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600761104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker