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Individual

DR. VINCENT MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D. LP

Contact information

Practice address
606 25TH AVE S, SUITE 105, SAINT CLOUD, MN 56301-4800
(320) 247-4737
(320) 365-0080
Mailing address
606 25TH AVE S, SUITE 105, SAINT CLOUD, MN 56301-4800
(320) 247-4737
(320) 365-0080

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP5676
MN
103TC0700X
Clinical Psychologist
Primary
LP5676
MN
103TH0004X
Health Psychologist
LP5676
MN

Other

Enumeration date
08/15/2012
Last updated
10/25/2021
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