Provider Demographics
NPI:1225320591
Name:ENGELHARD, AMY RUTH MILLER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:RUTH MILLER
Last Name:ENGELHARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:RUTH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:5455 SMETANA DRIVE
Mailing Address - Street 2:APT. 1116
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9699
Mailing Address - Country:US
Mailing Address - Phone:952-239-5700
Mailing Address - Fax:
Practice Address - Street 1:3450 OLEARY LN
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2340
Practice Address - Country:US
Practice Address - Phone:651-454-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2046106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist