Provider Demographics
NPI:1538188875
Name:MILLER, ROBERT C (EDD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24063-0630
Mailing Address - Country:US
Mailing Address - Phone:540-250-3065
Mailing Address - Fax:540-552-0724
Practice Address - Street 1:2001 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6678
Practice Address - Country:US
Practice Address - Phone:540-250-3065
Practice Address - Fax:540-552-0724
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001829103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical