Provider Demographics
NPI:1982831285
Name:MILEY, WILLIAM M (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:MILEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2312
Mailing Address - Country:US
Mailing Address - Phone:908-725-8880
Mailing Address - Fax:908-725-5656
Practice Address - Street 1:62 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2312
Practice Address - Country:US
Practice Address - Phone:908-725-8880
Practice Address - Fax:908-725-5656
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00269300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical