Individual
MALLORY DAWN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
1831 MUD FORK RD, VERDUNVILLE, WV 25649
(304) 752-8972
Mailing address
1831 MUD FORK RD, VERDUNVILLE, WV 25649
(304) 752-8972
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
WV
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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