Individual
MRS. MARY LYNN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 N 9TH ST STE C, MODESTO, CA 95350-5814
(209) 558-4420
Mailing address
500 N 9TH ST STE C, MODESTO, CA 95350-5814
(209) 558-4420
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
574550
CA
Other
Enumeration date
07/17/2007
Last updated
08/07/2013
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