Individual
MS. THERESA JEANNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
114 ORCHARD LAKE RD, PONTIAC, MI 48341-2244
(248) 858-7766
(248) 858-7201
Mailing address
114 ORCHARD LAKE RD, PONTIAC, MI 48341-2244
(248) 858-7766
(248) 858-7201
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301001673
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883825
—
MI
Enumeration date
12/29/2010
Last updated
12/29/2010
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