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General NPI Number Information
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NPI Number | 1255991998
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Entity Type | Individual
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Provider Name | MARY KATE MILLER
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Gender | Female
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Dates
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Enumeration Date | 06/15/2019
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 4735 OGLETOWN STANTON RD STE 2223
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City | NEWARK
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State | DE
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Zip | 19713-8000
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Country | US
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Telephone | 302-623-2943
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Fax | 302-623-0201
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Provider Business Mailing Address
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Address Line | 4735 OGLETOWN STANTON RD STE 2223
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City | NEWARK
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State | DE
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Zip | 19713-8000
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Country | US
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Telephone | 302-623-2943
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Fax | 302-623-0201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 11158
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | B1-0011531
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License Number State | DE
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