Healthcare Provider Details

I. General information

NPI: 1205084209
Provider Name (Legal Business Name): KRISTIN LYNN ARNOLD MILES PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTIN LYNN ARNOLD PSY.D.

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11101 W LINCOLN AVE
WEST ALLIS WI
53227-1133
US

IV. Provider business mailing address

11101 W LINCOLN AVE
WEST ALLIS WI
53227-1133
US

V. Phone/Fax

Practice location:
  • Phone: 414-327-3000
  • Fax:
Mailing address:
  • Phone: 414-327-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3011-57
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: