Individual
MRS. BROOKE TAMARA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
6611 E CENTRAL AVE STE C, WICHITA, KS 67206-1937
(316) 650-1877
(316) 358-7713
Mailing address
705 N DEERFIELD CT, ANDOVER, KS 67002-7986
(316) 650-1877
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
8520
KS
1041C0700X
Clinical Social Worker
Primary
8520
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201069800 B
—
KS
05
—
201069800B
—
KS
Enumeration date
05/07/2013
Last updated
11/09/2022
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