Healthcare Provider Details

I. General information

NPI: 1598544009
Provider Name (Legal Business Name): TENZIN MILLER-DORJEE PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LYME RD
HANOVER NH
03755-1219
US

IV. Provider business mailing address

PO BOX 294
SOUTH ROYALTON VT
05068-0294
US

V. Phone/Fax

Practice location:
  • Phone: 781-866-1021
  • Fax:
Mailing address:
  • Phone: 781-866-1021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: