Individual
PATTI JANE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.
Contact information
Practice address
4368 SPRUCE RD, ST BONIFACIUS, MN 55375-1312
(612) 812-7857
Mailing address
4368 SPRUCE RD, ST BONIFACIUS, MN 55375-1312
(952) 446-1182
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3515
MN
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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