Individual
MR. BRADLEY A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A. LMSW QSUDP
Contact information
Practice address
5583 N GLENWOOD ST, GARDEN CITY, ID 83714-1336
(208) 287-2564
Mailing address
5583 N GLENWOOD ST, GARDEN CITY, ID 83714-1336
(208) 287-2564
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-34787
ID
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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