Provider Demographics
NPI:1669606828
Name:JULIANN MILLER, MA, LP
Entity type:Organization
Organization Name:JULIANN MILLER, MA, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LP
Authorized Official - Phone:952-929-1110
Mailing Address - Street 1:6800 FRANCE AVE S
Mailing Address - Street 2:SUITE 560
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2007
Mailing Address - Country:US
Mailing Address - Phone:952-929-1110
Mailing Address - Fax:952-929-1117
Practice Address - Street 1:6800 FRANCE AVE S
Practice Address - Street 2:SUITE 560
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2007
Practice Address - Country:US
Practice Address - Phone:952-929-1110
Practice Address - Fax:952-929-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-03
Last Update Date:2009-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty