Individual
JAY A. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LLP
Contact information
Practice address
3330 CLAYSTONE ST SE, GRAND RAPIDS, MI 49546-7716
(616) 949-7460
(616) 949-3018
Mailing address
PO BOX 30516, DEPT 6065, LANSING, MI 48909-8016
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301014766
MI
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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