Individual
MR. CHARLES MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-2974
(215) 831-2929
Mailing address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124
(215) 831-2836
(215) 831-2929
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
CW015981
PA
104100000X
Social Worker
Primary
SW001450E
PA
Other
Enumeration date
09/06/2007
Last updated
09/24/2008
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