Healthcare Provider Details

I. General information

NPI: 1760222988
Provider Name (Legal Business Name): RICHARD KOJO MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TOWER OAKS BLVD STE 500
ROCKVILLE MD
20852-4377
US

IV. Provider business mailing address

37 N BROADWAY ST
AKRON OH
44308-1910
US

V. Phone/Fax

Practice location:
  • Phone: 301-444-5001
  • Fax:
Mailing address:
  • Phone: 330-535-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1114976701
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: