Healthcare Provider Details

I. General information

NPI: 1366540155
Provider Name (Legal Business Name): AMY K MILLER PSY.D, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WILLMAR AVE SW AFFILIATED COMMUNITY MEDICAL CENTERS
WILLMAR MN
56201-3591
US

IV. Provider business mailing address

101 WILLMAR AVE SW AFFILIATED COMMUNITY MEDICAL CENTERS
WILLMAR MN
56201-3591
US

V. Phone/Fax

Practice location:
  • Phone: 320-231-5000
  • Fax: 320-231-5067
Mailing address:
  • Phone: 320-231-5000
  • Fax: 320-231-5067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: