Individual
DOMINIC MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Mailing address
381 COLONIAL CIR, VACAVILLE, CA 95687-6914
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
—
Other
Enumeration date
07/24/2017
Last updated
11/01/2024
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