Individual
MIKI BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
506 LAMPLITE LN, WILLISTON, VT 05495-7709
(802) 305-0266
Mailing address
PMB 229, 34 BLAIR PARK RD STE 104, WILLISTON, VT 05495-7991
(802) 305-0266
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0136361
VT
Other
Enumeration date
05/24/2025
Last updated
07/09/2025
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