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General NPI Number Information
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NPI Number | 1316253214
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Entity Type | Organization
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Legal Business Name | JENNIFER L. MILLER, PH.D., LP, LLC
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 110 2ND ST S STE 303
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City | WAITE PARK
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State | MN
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Zip | 56387-1314
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Country | US
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Telephone | 320-217-6025
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Fax | 320-774-3005
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Provider Business Mailing Address
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Address Line | 110 2ND ST. S. SUITE #303
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City | WAITE PARK
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State | MN
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Zip | 56387
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Country | US
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Telephone | 320-217-6025
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. JENNIFER L. MILLER
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Credential | PH.D., LP
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Telephone | 320-217-6025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LP 4367
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License Number State | MN
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