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General NPI Number Information
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NPI Number | 1720243371
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Entity Type | Individual
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Provider Name | KATHLEEN A. SANDAL-MILLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 19755 E PIKES PEAK CT SUITE 202
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City | PARKER
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State | CO
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Zip | 80138-7414
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Country | US
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Telephone | 303-841-0529
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Fax | 720-851-3075
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Provider Business Mailing Address
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Address Line | PO BOX 1057
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City | PARKER
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State | CO
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Zip | 80134-1057
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Country | US
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Telephone | 303-841-0529
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Fax | 720-851-3075
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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 | 1651
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License Number State | CO
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