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Individual

DAVID C. MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
901 DOUGLAS AVE, LAS VEGAS, NM 87701-3928
(505) 454-5700
(505) 454-5702
Mailing address
559 VEGAS DR, LAS VEGAS, NM 87701-4690
(505) 425-0158
(505) 454-5702

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
265261
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103TS0200X
NM
Enumeration date
03/16/2007
Last updated
07/09/2007
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