| NPI | 1659434488 |
|---|---|
| Former Name | RICKY EARL MILLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL 9037) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 1047) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 9037) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2018-11-11 |