Individual
DR. D'LANE SALLY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
404 BARATARIA LN, FORT WALTON BEACH, FL 32547-3698
(850) 243-8086
(850) 243-2702
Mailing address
404 BARATARIA LN, FORT WALTON BEACH, FL 32547-3698
(850) 243-8086
(850) 243-2702
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00003359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59-3736816
GROUP TAX ID
FL
01
—
75407
BCBS
FL
01
—
7944548
AETNA
—
Enumeration date
01/26/2006
Last updated
12/08/2024
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