Individual
DR. NICOLE MARIE-POUPENEY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HSPP
Contact information
Practice address
8495 CRATER LAKE HWY, BLDG. 240 RM 109 -MAIL STOP 116, WHITE CITY, OR 97503
(541) 826-2111
(541) 830-3516
Mailing address
8495 CRATER LAKE HWY, BLDG. 240 RM 109 -MAIL STOP 116, WHITE CITY, OR 97503
(541) 826-2111
(541) 830-3516
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
20042459A
IN
Other
Enumeration date
11/10/2010
Last updated
03/11/2013
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