Individual
IVY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., L.P.
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-3036
Mailing address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-3036
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP5898
MN
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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