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Individual

MARTHA J MILLER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
804 KENYON RD, STE A, FORT DODGE, IA 50501
(515) 574-6120
(515) 574-6135
Mailing address
804 KENYON RD, STE A, FORT DODGE, IA 50501
(515) 574-6120
(515) 574-6135

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
02039
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0218438
IA
01
10198
BCBS
01
7298
MIDLANDS CHOICE
Enumeration date
04/28/2006
Last updated
07/08/2007
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