Provider Demographics
NPI:1689881427
Name:MILLER, KERSTIN (MDIV, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KERSTIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MDIV, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3414
Mailing Address - Country:US
Mailing Address - Phone:610-889-3856
Mailing Address - Fax:
Practice Address - Street 1:171 W LANCASTER AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1775
Practice Address - Country:US
Practice Address - Phone:610-889-0419
Practice Address - Fax:610-889-1537
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000261106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist