Individual
AMANDA JANE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
3225 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9334
(163) 641-5006
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361006485
MI
1041C0700X
Clinical Social Worker
—
—
3747P1801X
Personal Care Attendant
6301016613
MI
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/07/2018
Last updated
04/21/2021
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