Provider Demographics
NPI:1174632038
Name:RABIN MILLER, KATHRYN E (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:RABIN MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PARMAN PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4138
Mailing Address - Country:US
Mailing Address - Phone:210-860-7610
Mailing Address - Fax:855-532-9272
Practice Address - Street 1:22 PARMAN PLACE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4138
Practice Address - Country:US
Practice Address - Phone:210-860-7610
Practice Address - Fax:855-532-9272
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081MROtherBCBS
TX0081MROtherBCBS
TX611836Medicare PIN