Provider Demographics
NPI:1437489747
Name:MILLER, MELISSA CARPENTIER (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:CARPENTIER
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 1:5680 HIGHWAY 6 # 134
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4188
Mailing Address - Country:US
Mailing Address - Phone:832-945-1377
Mailing Address - Fax:
Practice Address - Street 1:4501 CARTWRIGHT RD STE 705
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3541
Practice Address - Country:US
Practice Address - Phone:281-969-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35056103TC0700X
IN20042395103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200969690Medicaid