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Organization
IMAGE TRANSFORMATION INSTITUTE
Active
Organization
IMAGE TRANSFORMATION INSTITUTE
Active
Other names
PsychTech
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MICHAEL MILLER PH.D. (PRESIDENT)
(626) 429-4945
Entity
Organization
Contact information
Practice address
1343 STRATFORD CT, DEL MAR, CA 92014-2327
(626) 429-4945
(858) 724-3585
Mailing address
1111 KLISH WAY, DEL MAR, CA 92014-2633
(626) 676-5942
(858) 724-3585
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WCP20630A
PPIN FOR ROBERT MILLER CP
CA
Enumeration date
07/01/2006
Last updated
06/27/2019
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