| Ronald B. Miller, Phd, Pllc | |
|
123 Ethan Allen Ave Colchester VT 05446-3311 | |
| (802) 654-7075 | |
| Not Available |
| Full Name | Ronald B. Miller, Phd, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 123 Ethan Allen Ave, Colchester, Vermont |
| Authorized Official Name and Position | Ronald B. Miller (PSYCHOLOGIST/MANAGER) |
| Authorized Official Contact | 8026547075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald B. Miller, Phd, Pllc 94 Butternut Ln Shelburne VT 05482-6925 Ph: (802) 654-7075 | Ronald B. Miller, Phd, Pllc 123 Ethan Allen Ave Colchester VT 05446-3311 Ph: (802) 654-7075 |
| NPI Number | 1720401250 |
|---|---|
| Provider Enumeration Date | 02/04/2014 |
| Last Update Date | 02/04/2014 |
| Medicare PECOS PAC ID | 9234362351 |
|---|---|
| Medicare Enrollment ID | O20140425000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720401250 | NPI | - | NPPES |
| 1010121 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 056 (Vermont) | Primary |
| Provider Name | Ronald B. Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720173370 PECOS PAC ID: 3870591472 Enrollment ID: I20070611000198 |
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