Basic Information
| Provider Information | |||||||||
| NPI: | 1841490711 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 554 NORTH DUKE STREET | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175603782 | ||||||||
| FaxNumber: | 7175603787 | ||||||||
| Practice Location | |||||||||
| Address1: | 554 N DUKE ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175603782 | ||||||||
| FaxNumber: | 7175603787 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW016935 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.