Individual
JEANETTE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
3500 CARNEGIE AVE, CLEVELAND, OH 44115-2641
(440) 314-5245
Mailing address
3500 CARNEGIE AVE, CLEVELAND, OH 44115-2641
(440) 314-5245
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I 0009197
OH
1041C0700X
Clinical Social Worker
Primary
I.0009197
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770854218
—
OH
Enumeration date
01/13/2012
Last updated
05/02/2022
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