Individual
CARLY MIYAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W BIG BEAVER RD STE 107, TROY, MI 48084-3507
(248) 573-7417
(231) 237-7014
Mailing address
1740 W BIG BEAVER RD STE 107, TROY, MI 48084-3507
(248) 573-7417
(231) 237-7014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6851120800
MI
Other
Enumeration date
09/19/2025
Last updated
09/19/2025
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