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Individual

MS. AMANDA R MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
125 CHAPARREL BLVD NW, DEMING, NM 88030-8629
(575) 546-4800
(575) 546-0685
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
M-08913
NM
1041C0700X
Clinical Social Worker
Primary
C-09740
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18677037
NM
Enumeration date
06/26/2014
Last updated
12/14/2016
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