Provider Demographics
NPI:1043327612
Name:MILLER, SUE BARRICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:BARRICK
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 JAMESTOWN DR.
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3948
Mailing Address - Country:US
Mailing Address - Phone:770-833-9966
Mailing Address - Fax:678-513-0743
Practice Address - Street 1:6740 JAMESTOWN DR.
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3948
Practice Address - Country:US
Practice Address - Phone:770-833-9966
Practice Address - Fax:678-513-0743
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002513103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical