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Individual

JOHN LAURENCE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
144 W 27TH ST, 3R, NEW YORK, NY 10001-6214
(212) 645-8780
(212) 645-8780
Mailing address
144 W 27TH ST, 3R, NEW YORK, NY 10001-6235
(212) 645-8780
(212) 645-8780

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
014068
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
O3113384
NY
Enumeration date
06/12/2009
Last updated
12/27/2010
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