Doctor Name: | DR. MILES DILLER |
NPI Number: | 1144361544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 723 |
Business Practice Address: | 489 Main St Prince Frederick, MD - 206783187 |
Business Phone Number: | 4105353947 |
Business Fax Number: | 3016099091 |
Mailing Address: | Po Box 2924, LA PLATA |
State: | MD |
Postal Code: | 206462984 |
Phone Number: | 3016099887 |
Fax Number: | 3016099091 |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 723 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |