Individual
MRS. AUDREY BARBARA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWR
Contact information
Practice address
21 E 2ND ST STE 105, RIVERHEAD, NY 11901-4686
(631) 369-8310
(631) 369-8310
Mailing address
21 E 2ND ST STE 105, RIVERHEAD, NY 11901-4686
(631) 369-8310
(631) 369-8310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R055802-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247701
VALUE OPTIONS
NY
01
—
270174000
MAGELLAN
NY
01
—
7043026
AETNA
NY
01
—
ND740
EMPIRE BC BS
NY
Enumeration date
11/07/2006
Last updated
04/14/2020
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