Provider Demographics
NPI:1902553068
Name:MILLER, CHRISTINE A (LSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 EMERSON CT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3443
Mailing Address - Country:US
Mailing Address - Phone:609-412-5223
Mailing Address - Fax:
Practice Address - Street 1:802 TILTON RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1233
Practice Address - Country:US
Practice Address - Phone:609-377-8074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06450300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker