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NPI Code Detail

MEDICARE: DR. DEBORAH J MILLER PHD

MEDICARE: DR. DEBORAH J MILLER PHD
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
1103T00000XPsychologist20042889AIN

General Provider Information

NPI Number : 1609137058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBORAH J MILLER PHD
Provider Business Mailing Address
First Line : 725 W ADAMS ST
Second Line :
City : MUNCIE
State : IN
Zip : 47305-2219
Country : US
Telephone Number : 765-716-0767
Fax Number :
Provider Business Practice Location Address
First Line : 1714 W ROYALE DR
Second Line :
City : MUNCIE
State : IN
Zip : 47304-2240
Country : US
Telephone Number : 765-587-4895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2012
Last Update Date : 03/30/2021

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