Healthcare Provider Details
I. General information
NPI: 1710746482
Provider Name (Legal Business Name): MILLER PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7776 S POINTE PKWY W STE 250
PHOENIX AZ
85044-5428
US
IV. Provider business mailing address
3071 SILVERWOOD DR
LOS ALAMITOS CA
90720-4033
US
V. Phone/Fax
- Phone: 480-567-6996
- Fax:
- Phone: 480-567-6996
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALICIA
R
MILLER
Title or Position: LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 480-567-6996