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General NPI Number Information
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NPI Number | 1427171388
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Entity Type | Individual
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Provider Name | WILEY MILLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 300 SAINT JAMES ST SUITE 104
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City | COLUMBIA
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State | MO
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Zip | 65201-5160
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Country | US
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Telephone | 573-864-8574
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7382
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City | COLUMBIA
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State | MO
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Zip | 65205-7382
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Country | US
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Telephone | 573-864-8574
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0467
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License Number State | MO
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