Individual
EBONI LAQUITA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P-LCSW
Contact information
Practice address
2817 REILLY ST, MCXC COD CREDENTIALS WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-7324
(910) 907-8922
Mailing address
2817 REILLY ROAD, MCXC-COD CREDENTIALS , WOMACK ARMY MEDICAL CENTER, FAYETTEVILLE, NC 28310
(910) 907-8922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P003720
NC
Other
Enumeration date
12/22/2008
Last updated
12/23/2008
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