Individual
MARK EDISON MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOCIAL WORKER
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2501
(317) 988-3243
Mailing address
3440 E FALL CREEK PARKWAY NORTH DR, INDIANAPOLIS, IN 46205-3693
(317) 283-9042
(317) 988-3243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003626A
IN
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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