Individual
ANDREA E. MILLER-BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
805 CHURCH ST, DECATUR, GA 30030-1870
(404) 354-4112
(404) 377-6798
Mailing address
PO BOX 2851, DECATUR, GA 30031-2851
(404) 354-4112
(404) 377-7287
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003189
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12018036
CAQH:
GA
Enumeration date
05/11/2010
Last updated
05/11/2010
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