Doctor Name: | DR. CONSTANTINA MILLER |
NPI Number: | 1235405838 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 0138941 |
Business Practice Address: | 299 Sycamore Ln Islandia, NY - 117491586 |
Business Phone Number: | 6313485109 |
Business Fax Number: | |
Mailing Address: | 299 Sycamore Ave, A. T. Morrow School ISLANDIA |
State: | NY |
Postal Code: | 117491742 |
Phone Number: | 6313485109 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2012 |
NPI Last Update Date: | 04/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 0138941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |