Healthcare Provider Details

I. General information

NPI: 1164121976
Provider Name (Legal Business Name): AUBREY MILLER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 NORTHLAND DR
MENDOTA HEIGHTS MN
55120-1288
US

IV. Provider business mailing address

1155 NORTHLAND DR
MENDOTA HEIGHTS MN
55120-1288
US

V. Phone/Fax

Practice location:
  • Phone: 612-223-8898
  • Fax: 612-223-8899
Mailing address:
  • Phone: 612-223-8898
  • Fax: 612-223-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC05555
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: