Healthcare Provider Details

I. General information

NPI: 1174632038
Provider Name (Legal Business Name): KATHRYN E RABIN MILLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PARMAN PLACE
SAN ANTONIO TX
78230-4138
US

IV. Provider business mailing address

22 PARMAN PLACE
SAN ANTONIO TX
78230-4138
US

V. Phone/Fax

Practice location:
  • Phone: 210-860-7610
  • Fax: 855-532-9272
Mailing address:
  • Phone: 210-860-7610
  • Fax: 855-532-9272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number35391
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: