Provider Demographics
NPI:1306992532
Name:MIKLOS, CAROL S (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:S
Last Name:MIKLOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41 BOX 6187
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464
Mailing Address - Country:US
Mailing Address - Phone:01144163-852-3308
Mailing Address - Fax:
Practice Address - Street 1:48 MDO
Practice Address - Street 2:UNIT 5210 BOX 230
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461-0230
Practice Address - Country:US
Practice Address - Phone:01144163-852-8124
Practice Address - Fax:01144163-852-8022
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015912103TC0700X
NY016434103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical