Individual
KEVIN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
415 E ROSSER AVE, SUITE 113, BISMARCK, ND 58501-4058
(701) 222-6670
(701) 222-6644
Mailing address
415 E ROSSER AVE, SUITE 113, BISMARCK, ND 58501-4058
(701) 222-6670
(701) 222-6644
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3041
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79229
—
ND
Enumeration date
04/29/2014
Last updated
04/29/2014
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