Individual
DR. MARK LYNN MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSY.D., L.P.
Contact information
Practice address
800 E 28TH ST, #17701, MINNEAPOLIS, MN 55407-3723
(612) 863-5327
(612) 863-2596
Mailing address
3452 46TH AVE S, MINNEAPOLIS, MN 55406-2931
(612) 722-7168
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP2306
MN
103TC0700X
Clinical Psychologist
LP2306
MN
103TP2701X
Group Psychotherapy Psychologist
Primary
LP2306
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012262
PREFERRED ONE
FM
01
—
263S5MI
BLUE CROSS/BLUE
MN
01
—
61-77458
UBH/SELECTCARE
FM
Enumeration date
06/09/2006
Last updated
09/11/2025
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