Miller, Mark Lynn

Miller, Mark Lynn is an individual health care provider with primary practice located at 800 E 28Th St #17701, Minneapolis MN 55407-3723. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Miller, Mark Lynn can be contacted via phone (612) 863-5327.

Contact Information

Primary practice address
800 E 28Th St #17701 Minneapolis MN 55407-3723
Phone: (612) 863-5327
Fax: (612) 863-2596
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP2306 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP2306 Minnesota
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X LP2306 Minnesota

Profile Details

NPI number 1184665390
LBN Legal business name Miller, Mark Lynn
Credentials PSY.D., L.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jul 8th, 2007 - 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 1184665390 NPPES
Fm Other 1012262 PREFERRED ONE
Fm Other 263S5MI PREFERRED ONE
Fm Other 61-77458 PREFERRED ONE

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