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Individual

CRYSTAL MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3901 MAINE AVE, BALTIMORE, MD 21207-7421
(410) 396-0571
(410) 396-0396
Mailing address
3901 MAINE AVE, BALTIMORE, MD 21207-7421
(410) 396-0571
(410) 396-0396

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
07278
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07278
SOCIAL WORK LISCENCE
MD
Enumeration date
05/17/2019
Last updated
06/11/2019
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