MEDICARE: ANNE MILLER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	129107	KY
2	103TC0700X	Clinical Psychologist	129107	KY

General Provider Information

NPI Number	:	1174061675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MILLER PH.D.

Provider Business Mailing Address
First Line	:	9400 WILLIAMSBURG PLZ STE 310
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-6016
Country	:	US
Telephone Number	:	502-627-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 WILLIAMSBURG PLZ STE 310
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-6016
Country	:	US
Telephone Number	:	502-627-0303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2017
Last Update Date	:	03/06/2026

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