Provider Demographics
NPI:1447561477
Name:MILLER, DAVID W (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:MILLER
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-3323
Mailing Address - Country:US
Mailing Address - Phone:518-523-2474
Mailing Address - Fax:
Practice Address - Street 1:34 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:NY
Practice Address - Zip Code:12946-3323
Practice Address - Country:US
Practice Address - Phone:518-523-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool