| Ms Tara Elizabeth Miller, LICSW | |
|
603 Bruce St, Crookston, MN 56716-2914 | |
| (218) 281-3940 | |
| (218) 281-6261 |
| Full Name | Ms Tara Elizabeth Miller |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 603 Bruce St, Crookston, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851611222 | NPI | - | NPPES |
| 41-0851371 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 18905 (Minnesota) | Primary |
| Entity Name | Alluma Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508835133 PECOS PAC ID: 6709787609 Enrollment ID: O20040302000004 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Tara Elizabeth Miller, LICSW 603 Bruce St, Crookston, MN 56716-2914 Ph: (218) 281-3940 | Ms Tara Elizabeth Miller, LICSW 603 Bruce St, Crookston, MN 56716-2914 Ph: (218) 281-3940 |
Denise Elaine Hammer, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 Fax: 218-281-6261 | |
Rachel Lynn Winter, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-280-3933 | |
Angela Marie Carlson, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 Fax: 218-281-6261 | |
Shauna R Reitmeier, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 | |
Stephanie Kaitlyn Philyaw, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 | |
Casandra Kay Anderson, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 | |
Ms. Tricia Jeanne Hellerud, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 603 Bruce St, Crookston, MN 56716 Phone: 218-281-3940 Fax: 218-281-6261 |