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General NPI Number Information
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NPI Number | 1619196987
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Entity Type | Organization
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Legal Business Name | CAROLE KUNKLE-MILLER, PHD
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 1720 WASHINGTON RD SUITE 208
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City | PITTSBURGH
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State | PA
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Zip | 15241-1208
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Country | US
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Telephone | 412-854-4887
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Fax | 412-386-3733
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Provider Business Mailing Address
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Address Line | 1720 WASHINGTON RD SUITE 208
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City | PITTSBURGH
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State | PA
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Zip | 15241-1208
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Country | US
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Telephone | 412-854-4887
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Fax | 412-386-3733
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROLE KUNKLE-MILLER
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Credential | PH.D.
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Telephone | 412-854-4887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS004214L
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License Number State | PA
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