Individual
JACOB THOMAS MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
6611 E CENTRAL AVE STE C, WICHITA, KS 67206-1937
(316) 706-1873
Mailing address
1824 N NEWBERRY CIR, DERBY, KS 67037-2314
(316) 706-1873
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW13087
KS
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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