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Individual

MS. BERYL M MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3424 TABLE ROCK DR, GASTONIA, NC 28052-5436
(704) 517-4527
(704) 372-2309
Mailing address
3424 TABLE ROCK DR, GASTONIA, NC 28052-5436
(704) 517-4527
(704) 372-2309

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C003740
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139HN
NC HEALTH CHOICE
NC
05
6002607
NC
Enumeration date
01/02/2007
Last updated
12/07/2012
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