Miller, Mistala

Miller, Mistala is an individual health care provider with primary practice located at 120 S 13Th St , St Maries ID 83861-1627. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Miller, Mistala can be contacted via phone (208) 245-4363.

Contact Information

Primary practice address
120 S 13Th St St Maries ID 83861-1627
Phone: (208) 245-4363
Fax: (208) 245-4349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LMSW36012 Idaho
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-38874 Idaho

Profile Details

NPI number 1598213183
LBN Legal business name Miller, Mistala
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2016
Last updated Jul 8th, 2024 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598213183 NPPES
Washington MEDICAID 2122473

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