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General NPI Number Information
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NPI Number | 1760940852
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Entity Type | Individual
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Provider Name | CHELSEY MILLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 302 5TH AVE STE 1106
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City | NEW YORK
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State | NY
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Zip | 10001-3604
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Country | US
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Telephone | 516-236-2529
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Fax |
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Provider Business Mailing Address
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Address Line | 301 W 106TH ST APT 2D
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City | NEW YORK
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State | NY
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Zip | 10025-0033
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Country | US
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Telephone | 516-236-2529
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021475-1
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License Number State | NY
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