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NPI Code Detail

MEDICARE: KIMBERLY L MILLER

MEDICARE:   KIMBERLY L MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1962930800
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY L MILLER
Provider Business Mailing Address
First Line : PO BOX 189
Second Line :
City : PRESTON
State : OK
Zip : 74456-0189
Country : US
Telephone Number : 918-978-5038
Fax Number :
Provider Business Practice Location Address
First Line : 6715 N MAY AVE STE 102
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3422
Country : US
Telephone Number : 918-978-5038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2017
Last Update Date : 07/08/2019

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Directions to “ KIMBERLY L MILLER ” Practice Location

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