Provider Demographics
NPI:1053556662
Name:MILLER, RHONDA JOVETTE (LMSW)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:JOVETTE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16249 EASTWIND ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-3180
Mailing Address - Country:US
Mailing Address - Phone:313-467-7215
Mailing Address - Fax:
Practice Address - Street 1:19304 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-1202
Practice Address - Country:US
Practice Address - Phone:313-467-3918
Practice Address - Fax:734-442-7054
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010708341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical