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NPI Code Detail

MEDICARE: TRISHA T MILLER PHD INC

MEDICARE: TRISHA T MILLER PHD INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist496SD

General Provider Information

NPI Number : 1417237165
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRISHA T MILLER PHD INC
Provider Business Mailing Address
First Line : 1818 W FULTON ST
Second Line : SUITE 201
City : RAPID CITY
State : SD
Zip : 57702-4377
Country : US
Telephone Number : 605-348-6565
Fax Number : 605-341-7409
Provider Business Practice Location Address
First Line : 1818 W FULTON ST
Second Line : SUITE 201
City : RAPID CITY
State : SD
Zip : 57702-4377
Country : US
Telephone Number : 605-348-6565
Fax Number : 605-341-7409
Authorized Official
Title or Position : CLINICAL CHILD PSYCHOLOGIST
Name : TRISHA T MILLER
Credential : PHD
Telephone Number : 605-348-6565
Provider Enumeration Date : 08/26/2011
Last Update Date : 05/20/2013

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Directions to “TRISHA T MILLER PHD INC ” Practice Location

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