Provider Demographics
NPI:1992897961
Name:MARIAN L MILLER PSYD INC
Entity type:Organization
Organization Name:MARIAN L MILLER PSYD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-262-3345
Mailing Address - Street 1:1454 AKEKE PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4218
Mailing Address - Country:US
Mailing Address - Phone:808-262-3345
Mailing Address - Fax:808-262-1017
Practice Address - Street 1:1454 AKEKE PL
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4218
Practice Address - Country:US
Practice Address - Phone:808-262-3345
Practice Address - Fax:808-262-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty