Provider Demographics
NPI:1346652625
Name:MILLER, REBEKAH L (LMFT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 GOLDEN VALLEY RD
Mailing Address - Street 2:SUITE 133
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4562
Mailing Address - Country:US
Mailing Address - Phone:651-399-6920
Mailing Address - Fax:763-546-2197
Practice Address - Street 1:7575 GOLDEN VALLEY RD
Practice Address - Street 2:SUITE 133
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4562
Practice Address - Country:US
Practice Address - Phone:651-399-6920
Practice Address - Fax:763-546-2197
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2308106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist