Provider Demographics
NPI:1669118634
Name:MILLER, KATIE FARNHAM (CAT)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:FARNHAM
Last Name:MILLER
Suffix:
Gender:F
Credentials:CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3523
Mailing Address - Country:US
Mailing Address - Phone:970-241-2948
Mailing Address - Fax:
Practice Address - Street 1:1170 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3523
Practice Address - Country:US
Practice Address - Phone:970-241-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0008096101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACA.0008096OtherACA.0008096