Provider Demographics
NPI:1194701987
Name:MILLER, KATHRYN ELAINE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ELAINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2117
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75802-2117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1025 N MALLARD ST
Practice Address - Street 2:SUITE 106
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-7737
Practice Address - Country:US
Practice Address - Phone:903-948-9203
Practice Address - Fax:903-723-8409
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health