Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 5646 | NJ |
NPI | 1104338813 |
---|---|
Provider Name | Dr. Suzi Millar |
First Address | Edison, NJ 08817-4002 |
Second Address | Edison, NJ 08817-4002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2017 |
Last Update Date | 03/11/2017 |