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General NPI Number Information
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NPI Number | 1780565176
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Entity Type | Individual
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Provider Name | MCKENZIE L MILLER PHD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 845 EL CAMINO REAL
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City | MENLO PARK
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State | CA
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Zip | 94025-4807
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Country | US
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Telephone | 231-463-4966
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Fax |
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Provider Business Mailing Address
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Address Line | 442 NEW SCOTLAND AVE APT D
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City | ALBANY
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State | NY
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Zip | 12208-2738
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 027525
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License Number State | NY
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