Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1293 | KS |
Y | 103TC0700X | Clinical Psychologist | 1293 | KS |
NPI | 1013085562 |
---|---|
Provider Name | Dr. Tonya L Miles |
First Address | Overland Park, KS 66210-1213 |
Second Address | Overland Park, KS 66210-1213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 02/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200297160 | (05) | KS |
200297160B | (05) | KS |