Healthcare Provider Details

I. General information

NPI: 1518452036
Provider Name (Legal Business Name): LEIGH MILLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7611 MAPLE ST STE A2
NEW ORLEANS LA
70118-5068
US

IV. Provider business mailing address

320 MOUND AVE
NEW ORLEANS LA
70124-1836
US

V. Phone/Fax

Practice location:
  • Phone: 954-673-2318
  • Fax:
Mailing address:
  • Phone: 954-673-2318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1452
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number1452
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: