Individual
MR. THOMAS LEE MILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1523 S BLUFF BLVD, CLINTON, IA 52732-6549
(563) 243-6054
Mailing address
1523 S BLUFF BLVD, CLINTON, IA 52732-6549
(563) 243-6054
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23379
BLUE CROSS BLUE SHIELD
IA
Enumeration date
08/15/2006
Last updated
07/08/2007
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