JONATHAN M MILLER PHD LP
Clinical Neuropsychologist
Eagan, Minnesota
Provider NPI: 1992790117
Provider Information:JONATHAN M MILLER PHD LP
Gender: M
Sole Proprietor
Practice Location:
2113 CLIFF DR EAGAN, MN 55122 US
Tel: 651-728-0922 Fax: --
Business Mailing Address:
2113 CLIFF DR EAGAN, MN 55122 US
Tel: 651-728-0922 Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | MN | LP4000 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
228524000 | MN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin