| Ivan J. Miller, Phd, Inc. | |
|
350 Broadway St Ste 210 Boulder CO 80305-3338 | |
| (303) 870-1529 | |
| Not Available |
| Full Name | Ivan J. Miller, Phd, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 350 Broadway St Ste 210, Boulder, Colorado |
| Authorized Official Name and Position | Ivan J Miller (OWNER) |
| Authorized Official Contact | 3038701529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan J. Miller, Phd, Inc. 350 Broadway St Ste 210 Boulder CO 80305-3338 Ph: (303) 870-1529 | Ivan J. Miller, Phd, Inc. 350 Broadway St Ste 210 Boulder CO 80305-3338 Ph: (303) 870-1529 |
| NPI Number | 1811614951 |
|---|---|
| Provider Enumeration Date | 10/19/2022 |
| Last Update Date | 10/19/2022 |
| Certification Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811614951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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