Individual
MR. MONIQUE MASSA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LP
Contact information
Practice address
308 12TH AVE S, BUFFALO, MN 55313-2321
(763) 682-4400
(763) 682-1353
Mailing address
1321 13TH ST N, ST CLOUD, MN 56303-2614
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3375
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6178046
MEDICA
—
01
—
922241042329
PREFERRED ONE
—
01
—
922S7MI
BCBS
—
01
—
HP48657
HEALTH PARTNERS
—
Enumeration date
07/11/2006
Last updated
07/08/2007
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