Provider Demographics
NPI:1760950307
Name:MIRELES, KARA H (LAMFT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:H
Last Name:MIRELES
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 OLD MAIN ST
Mailing Address - Street 2:STE 2,3,4
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056
Mailing Address - Country:US
Mailing Address - Phone:651-401-3062
Mailing Address - Fax:651-674-2534
Practice Address - Street 1:5842 OLD MAIN ST
Practice Address - Street 2:STE 2,3,4
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056
Practice Address - Country:US
Practice Address - Phone:651-401-3062
Practice Address - Fax:651-674-2534
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3543106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist