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Organization

IVAN J. MILLER, PHD, INC.

Active
Parent organization
BOULDER PSYCHOTHERAPISTS GUILD INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOULDER PSYCHOTHERAPISTS GUILD INC
Authorized official
IVAN J MILLER PHD (OWNER)
(303) 870-1529
Entity
Organization

Contact information

Practice address
350 BROADWAY ST STE 210, BOULDER, CO 80305-3338
(303) 870-1529
Mailing address
350 BROADWAY ST STE 210, BOULDER, CO 80305-3338
(303) 870-1529

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
10/19/2022
Last updated
10/19/2022
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