Provider Demographics
NPI:1457364010
Name:MILLER, MARIAN LOUISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:LOUISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 AKEKE PLACE
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4218
Mailing Address - Country:US
Mailing Address - Phone:808-262-3345
Mailing Address - Fax:808-240-1097
Practice Address - Street 1:1454 AKEKE PL
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4218
Practice Address - Country:US
Practice Address - Phone:808-262-3345
Practice Address - Fax:808-240-1097
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2015-11-23
Deactivation Date:2008-02-27
Deactivation Code:
Reactivation Date:2008-05-28
Provider Licenses
StateLicense IDTaxonomies
HIPSY647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical