Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PYS: 14798 | CA |
NPI | 1174582175 |
---|---|
Provider Name | Dr. Nicole G Miller |
First Address | Martinez, CA 94553-4668 |
Second Address | Martinez, CA 94553-4668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |