Individual
DIANNE LADON PHILLIPS-MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 882-0619
(208) 882-4774
Mailing address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 882-0619
(208) 882-4774
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY 288
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBH2228116
CIGNA
ID
01
—
N4460
BLUE CROSS OF IDAHO
ID
01
—
P9205
APS HEALTHCARE
ID
Enumeration date
04/27/2006
Last updated
07/08/2007
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