Organization
KATHRYN B. MILLER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN BREVARD MILLER PH.D. (PRESIDENT)
(763) 595-7294
Entity
Organization
Contact information
Practice address
5101 OLSON MEMORIAL HWY, SUITE 4004, GOLDEN VALLEY, MN 55422-5149
(763) 595-7294
(763) 595-7293
Mailing address
5101 OLSON MEMORIAL HWY, SUITE 4004, GOLDEN VALLEY, MN 55422-5149
(763) 595-7294
(763) 595-7293
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4359
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023640000
—
MN
01
—
365L0MI
BLUECROSS BLUESHIELD OF MN
MN
Enumeration date
06/12/2006
Last updated
05/20/2008
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