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General NPI Number Information
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NPI Number | 1932387768
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Entity Type | Individual
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Provider Name | JEANINE COURTNEY MILLER PHD
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Gender | Female
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 103 CONTINENTAL PL STE 120
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City | BRENTWOOD
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State | TN
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Zip | 37027-1086
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Country | US
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Telephone | 615-462-8980
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Fax |
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Provider Business Mailing Address
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Address Line | 5805 MONROE XING
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City | ANTIOCH
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State | TN
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Zip | 37013-3159
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Country | US
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Telephone | 615-578-8471
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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 | 11755
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License Number State | TN
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