Doctor Name: | DR. IRIS LYNN MILLER |
NPI Number: | 1134309974 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 4627 |
Business Practice Address: | 81 Wyman St Suite #3 Waban, MA - 024681519 |
Business Phone Number: | 6179694515 |
Business Fax Number: | |
Mailing Address: | 81 Wyman St, Suite #3 WABAN |
State: | MA |
Postal Code: | 024681519 |
Phone Number: | 6179694515 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2007 |
NPI Last Update Date: | 11/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4627 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |