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Individual

MR. TIMOTHY MICHAEL MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSW, LICDC-S

Contact information

Practice address
1441 PHALE D. HALE DR., COLUMBUS, OH 43203
(614) 257-3754
Mailing address
11122 GORSUCH RD, GALENA, OH 43021-9633
(419) 203-9314

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
001104
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101010101
1010101
01
NONE
Enumeration date
03/20/2020
Last updated
07/21/2022
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