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General NPI Number Information
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NPI Number | 1932308962
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Entity Type | Individual
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Provider Name | DENNIS R MILLER PHD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 7525 JOHN T WHITE RD
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City | FORT WORTH
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State | TX
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Zip | 76120-3311
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Country | US
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Telephone | 817-338-9553
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | ARLINGTON
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State | TX
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Zip | 76004-0428
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Country | US
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Telephone | 817-338-9553
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 10983
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW15499
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License Number State | TX
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