Organization
LAKESIDE PSYCHOLOGICAL SERVICES, LLC
Active
Organization
LAKESIDE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER MILLER PH.D. (CLINICAL PSYCHOLOGIST)
(970) 462-7206
Entity
Organization
Contact information
Practice address
3154 LAKESIDE DR APT 103, GRAND JUNCTION, CO 81506
(970) 462-7206
(970) 628-4207
Mailing address
915 LAKESIDE CT, GRAND JUNCTION, CO 81506-2815
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
07/23/2018
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