Provider Demographics
NPI:1255003752
Name:MILLER, NINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7286 LACABREAH DR APT 303
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5540
Mailing Address - Country:US
Mailing Address - Phone:317-508-3861
Mailing Address - Fax:
Practice Address - Street 1:8202 CLEARVISTA PKWY STE 9E
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1457
Practice Address - Country:US
Practice Address - Phone:317-426-9615
Practice Address - Fax:317-762-7903
Is Sole Proprietor?:No
Enumeration Date:2021-10-02
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist