Doctor Name: | DR. LAWRENCE J MILLER |
NPI Number: | 1093824237 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PY2451 |
Business Practice Address: | 10000 Bay Pines Blvd Bay Pines, FL - 33744 |
Business Phone Number: | 7273986661 |
Business Fax Number: | 7273989569 |
Mailing Address: | 6600 100th Way N Apt 24a, ST PETERSBURG |
State: | FL |
Postal Code: | 337084596 |
Phone Number: | 7273936290 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY2451 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |