Organization Name: | SUCCESS PSYCH SERVICES, INC. |
NPI Number: | 1003879396 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANNA S MILLER (CLINICAL PSYCHOLOGIST) |
Mailing Address: | 10560 Success Ln Suite B Centerville |
State: | OH US |
Postal Code: | 454583697 |
Phone Number: | 9378857415 |
Fax Number: | 9378857416 |
NPI Enumeration Date: | 04/08/2006 |
NPI Last Update Date: | 11/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4205 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |