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General NPI Number Information
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NPI Number | 1053319947
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Entity Type | Individual
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Provider Name | KIM PATRICIA MILLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 3355 LENOX RD NE STE 1000
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City | ATLANTA
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State | GA
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Zip | 30326-2000
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Country | US
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Telephone | 770-284-1044
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Fax |
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Provider Business Mailing Address
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Address Line | 23 WINTHROP DR
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City | SHARPSBURG
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State | GA
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Zip | 30277-2285
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Country | US
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Telephone | 347-204-4629
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Fax | 470-414-1096
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 016390
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016390
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY004728
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License Number State | GA
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