Provider Demographics
NPI:1578702304
Name:PAULA DIANNE MILTENBERGER, PHD, PA
Entity Type:Organization
Organization Name:PAULA DIANNE MILTENBERGER, PHD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:MILTENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-890-9880
Mailing Address - Street 1:9101 N CENTRAL EXPY STE 580
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-890-9880
Mailing Address - Fax:214-890-0993
Practice Address - Street 1:9101 N CENTRAL EXPY STE 580
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-890-9880
Practice Address - Fax:214-890-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33947103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty