Individual
MARY ANNA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
6950 146TH ST W, APPLE VALLEY, MN 55124-4513
(952) 432-1484
(952) 432-2328
Mailing address
19839 EMPEROR CT, FARMINGTON, MN 55024-8431
(651) 463-8026
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP4145
MN
103TC0700X
Clinical Psychologist
Primary
LP4145
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
546M7MI
BCBS
MN
01
—
6154468
MEDICA CHOICE
MN
01
—
HP29388
HEALTHPARTNERS
MN
01
—
P00331391
RR MEDICARE
MN
Enumeration date
05/26/2006
Last updated
09/11/2025
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