Provider Demographics
NPI:1376950121
Name:MILLER, JULIE LYNN (MS LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N MAIN ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-1525
Mailing Address - Country:US
Mailing Address - Phone:316-351-7644
Mailing Address - Fax:316-351-7689
Practice Address - Street 1:300 N MAIN ST
Practice Address - Street 2:SUITE 303
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-1525
Practice Address - Country:US
Practice Address - Phone:316-351-7644
Practice Address - Fax:316-351-7689
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2530106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist