Provider Demographics
NPI:1801174487
Name:RIETTA MILLER, LLC
Entity type:Organization
Organization Name:RIETTA MILLER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIETTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-831-6388
Mailing Address - Street 1:PO BOX 720143
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-4110
Mailing Address - Country:US
Mailing Address - Phone:405-831-6388
Mailing Address - Fax:405-858-0600
Practice Address - Street 1:1818 W LINDSEY ST
Practice Address - Street 2:SUITE C-210
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4162
Practice Address - Country:US
Practice Address - Phone:405-831-6388
Practice Address - Fax:405-858-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty