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General NPI Number Information
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NPI Number | 1992897961
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Entity Type | Organization
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Legal Business Name | MARIAN L MILLER PSYD INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 1454 AKEKE PL
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City | KAILUA
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State | HI
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Zip | 96734-4218
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Country | US
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Telephone | 808-262-3345
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Fax | 808-262-1017
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Provider Business Mailing Address
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Address Line | 1454 AKEKE PL
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City | KAILUA
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State | HI
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Zip | 96734-4218
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Country | US
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Telephone | 808-262-3345
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Fax | 808-262-1017
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIAN LOUISE MILLER
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Credential | PSYD
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Telephone | 808-262-3345
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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 | PSY647
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License Number State | HI
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