Healthcare Provider Details

I. General information

NPI: 1861841843
Provider Name (Legal Business Name): DANIELLE KAY MILLER TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 SCHAEFER RD STE 2
DEARBORN MI
48126-1974
US

IV. Provider business mailing address

6549 TOWN CENTER DR STE A
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 313-846-2606
  • Fax:
Mailing address:
  • Phone: 248-620-6400
  • Fax: 248-620-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301017119
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: