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Individual

KEITH MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
75 DOMINICAN RD, SUITE 207, LA PLACE, LA 70068-3400
(985) 224-2998
Mailing address
PO BOX 72, LA PLACE, LA 70069-0072
(504) 813-0071

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary

Other

Enumeration date
06/08/2016
Last updated
06/08/2016
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