Individual
DR. STEPHEN MIKSIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
35 PRINCETON RD, HAVERTOWN, PA 19083-3621
(610) 584-9721
(610) 584-9721
Mailing address
32799 OCEAN REACH DR, LEWES, DE 19958-4663
(610) 716-6590
(302) 200-7432
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PS004073L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS004073-L
LICENSED PSYCHOLOGIST
PA
Enumeration date
02/11/2007
Last updated
12/21/2022
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