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General NPI Number Information
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NPI Number | 1326320920
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Entity Type | Individual
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Provider Name | MATTHEW R MILETTE-WINFREE PHD
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Gender | Male
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | PSC 475
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City | FPO
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State | AP
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Zip | 96350-9998
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Country | US
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Telephone | 315-243-5485
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 475 BOX 1678
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City | FPO
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State | AP
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Zip | 96350-1678
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Country | US
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Telephone |
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Fax |
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY-1841
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY-1841
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License Number State | HI
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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 | PSY-1841
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License Number State | HI
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