Individual
DR. KEVIN WAYNE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2131 S WEBSTER AVE, SUITE 105, GREEN BAY, WI 54301-2288
(920) 366-7792
Mailing address
2131 S WEBSTER AVE, SUITE 105, GREEN BAY, WI 54301-2288
(920) 366-7792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2309-057
WI
Other
Enumeration date
11/20/2006
Last updated
11/04/2010
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