Individual
BREANNA MICHELLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LCSW
Contact information
Practice address
415 S MULFORD RD, ROCKFORD, IL 61108-3011
(815) 399-5700
Mailing address
4620 SOVEREIGN BLVD, ROCKFORD, IL 61108-6421
(815) 222-8884
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149.023843
IL
Other
Enumeration date
11/21/2021
Last updated
11/21/2021
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