Carlita Dionne Miller

Individual provider Active NPI Intellectual & Developmental Disabilities Psychologist · Dover, FL

NPI 1659560779 · NPPES record last updated Oct 15, 2007

Key facts

NPI
1659560779
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Practice address
1701 Crossfield Manor Dr
Dover, FL 33527-4946
Phone
(813) 681-6511
Fax
(813) 654-1419
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Yes
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1701 Crossfield Manor Dr
Dover, FL 33527-4946

Mailing address

1701 Crossfield Manor Dr
Dover, FL 33527-4946
Phone (813) 681-6511

Other providers in Dover, FL

All providers in Dover, FL · Intellectual & Developmental Disabilities Psychologist in Florida

Sources for this page

Verify at the official NPI Registry.