Miller, Kathryn Brevard

Miller, Kathryn Brevard is an sole proprietor health care provider with primary practice located at 5101 Olson Memorial Hwy Suite 4004, Golden Valley MN 55422-5149. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Miller, Kathryn Brevard can be contacted via phone (763) 595-7294.

Contact Information

Primary practice address
5101 Olson Memorial Hwy Suite 4004 Golden Valley MN 55422-5149
Phone: (763) 595-7294
Fax: (763) 595-7293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4359 Minnesota

Profile Details

NPI number 1558305565
LBN Legal business name Miller, Kathryn Brevard
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2006
Last updated May 20th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558305565 NPPES
Minnesota Other 365LOMI BLUECROSSBLUESHIELD
Minnesota MEDICAID 128427400 BLUECROSSBLUESHIELD

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