Provider Demographics
NPI:1518269729
Name:MILLER, HAROLD JOHN (ED D)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JOHN
Last Name:MILLER
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BOB WHITE
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-3325
Mailing Address - Country:US
Mailing Address - Phone:306-584-1084
Mailing Address - Fax:
Practice Address - Street 1:8 BOB WHITE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-3325
Practice Address - Country:US
Practice Address - Phone:306-584-1084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016882103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist