Individual
ANGELA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
141 DR TT LEWIS CIR, CHARLESTON, MS 38921-2400
(662) 647-5535
Mailing address
751 CHOCTAW ST, GRENADA, MS 38901-5317
(662) 417-7707
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PH4157
MS
1041C0700X
Clinical Social Worker
Primary
C11387
MS
Other
Enumeration date
10/11/2018
Last updated
12/21/2024
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