Provider Demographics
NPI:1740553130
Name:MINER, CHRISTIAN ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ROBERT
Last Name:MINER
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 1:116 STEEP HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1824
Mailing Address - Country:US
Mailing Address - Phone:203-848-7473
Mailing Address - Fax:203-557-8100
Practice Address - Street 1:116 STEEP HILL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1824
Practice Address - Country:US
Practice Address - Phone:203-848-7473
Practice Address - Fax:203-557-8100
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008435103TC0700X
CT003685103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical