Individual
LEONARD EZEKIEL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D., HSPP
Contact information
Practice address
257 E MAIN ST, NORTH VERNON, IN 47265-1510
(812) 346-2872
(812) 346-4172
Mailing address
257 E MAIN ST, NORTH VERNON, IN 47265-1510
(812) 346-2872
(812) 346-4172
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040350A
IN
103T00000X
Psychologist
KY-0594
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200147420A
—
IN
Enumeration date
08/24/2007
Last updated
07/29/2008
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