Doctor Name: | SCOTT G MILLER |
NPI Number: | 1326190992 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 1350 |
Business Practice Address: | 208 S Cedar St Sisters, OR - 97759 |
Business Phone Number: | 5415491300 |
Business Fax Number: | 5415491333 |
Mailing Address: | Po Box 1796, SISTERS |
State: | OR |
Postal Code: | 977591796 |
Phone Number: | 5415491300 |
Fax Number: | 5415491333 |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1350 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |