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Individual

MS. LYSA R MILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
992 W IDAHO AVE, ONTARIO, OR 97914-2111
(208) 741-3336
(541) 216-5066
Mailing address
3720 W WOODMONT DR, MERIDIAN, ID 83646-1033
(209) 703-0050

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
09/17/2021
Last updated
09/17/2021
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