Provider Demographics
NPI:1295832095
Name:MILLER, RONALD LEE (DMIN)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-1226
Mailing Address - Country:US
Mailing Address - Phone:814-734-4647
Mailing Address - Fax:814-734-4647
Practice Address - Street 1:2820 W 21ST ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2983
Practice Address - Country:US
Practice Address - Phone:814-882-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000217106H00000X
SC7960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist