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Individual

DR. MILES DILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
489 MAIN ST, PRINCE FREDERICK, MD 20678-3187
(410) 535-3947
(301) 609-9091
Mailing address
PO BOX 2924, LA PLATA, MD 20646-2984
(301) 609-9887
(301) 609-9091

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
02457
MD
103TC0700X
Clinical Psychologist
723
NM
103TS0200X
School Psychologist
267420
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Z4787
NM
Enumeration date
02/09/2007
Last updated
11/12/2014
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