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Organization

KEYSTONE PSYCHOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN WAYNE MILLER PHD (PSYCHOLOGIST)
(920) 366-7792
Entity
Organization

Contact information

Practice address
2131 S WEBSTER AVE, SUITE 105, GREEN BAY, WI 54301-2288
(920) 366-7792
(920) 227-4117
Mailing address
2131 S WEBSTER AVE, SUITE 105, GREEN BAY, WI 54301-2288
(920) 366-7792
(920) 227-4117

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
12/02/2007
Last updated
11/04/2010
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