Provider Demographics
NPI:1417237165
Name:TRISHA T MILLER PHD INC
Entity Type:Organization
Organization Name:TRISHA T MILLER PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL CHILD PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:605-348-6565
Mailing Address - Street 1:1818 W FULTON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-4377
Mailing Address - Country:US
Mailing Address - Phone:605-348-6565
Mailing Address - Fax:605-341-7409
Practice Address - Street 1:1818 W FULTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-4377
Practice Address - Country:US
Practice Address - Phone:605-348-6565
Practice Address - Fax:605-341-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD496103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty