Provider Demographics
NPI:1881092195
Name:JULIE MILLER CORP
Entity type:Organization
Organization Name:JULIE MILLER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:316-835-0303
Mailing Address - Street 1:4425 W ZOO BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-1620
Mailing Address - Country:US
Mailing Address - Phone:316-749-2007
Mailing Address - Fax:316-943-5554
Practice Address - Street 1:4425 W ZOO BLVD
Practice Address - Street 2:STE 3
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-1620
Practice Address - Country:US
Practice Address - Phone:316-749-2007
Practice Address - Fax:316-943-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2530251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health