Healthcare Provider Details

I. General information

NPI: 1396656930
Provider Name (Legal Business Name): MELANIE ELIZABETH MILLER PHD, PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 8TH ST
COLUMBIA MO
65201-4868
US

IV. Provider business mailing address

211 S 8TH ST
COLUMBIA MO
65201-4868
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-4677
  • Fax: 573-882-4583
Mailing address:
  • Phone: 573-882-4677
  • Fax: 573-882-4583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2026034974
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: