Provider Demographics
NPI:1386846103
Name:MILLER, MEREDITH LYNN (MS, LCMFT)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 N AMIDON AVE STE 365
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2160
Mailing Address - Country:US
Mailing Address - Phone:316-734-2667
Mailing Address - Fax:316-267-2007
Practice Address - Street 1:1999 N AMIDON AVE STE 365
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2160
Practice Address - Country:US
Practice Address - Phone:316-734-2667
Practice Address - Fax:316-267-2007
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCMFT 863106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist