Provider Demographics
NPI:1669416509
Name:MILES, REBECCA RASMUSSEN (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:RASMUSSEN
Last Name:MILES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15138 W 132ND ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1500
Mailing Address - Country:US
Mailing Address - Phone:913-406-1885
Mailing Address - Fax:
Practice Address - Street 1:15138 W 132ND ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1500
Practice Address - Country:US
Practice Address - Phone:913-406-1885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1301103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS34799031OtherBLUE CROSS BLUE SHIELD