Provider Demographics
NPI:1679254635
Name:MILLAR, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MILLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAM
Other - Middle Name:
Other - Last Name:MILLAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7916 MOUNTAIN MAN WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1593
Mailing Address - Country:US
Mailing Address - Phone:702-339-0382
Mailing Address - Fax:
Practice Address - Street 1:7916 MOUNTAIN MAN WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1593
Practice Address - Country:US
Practice Address - Phone:702-339-0382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-3648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist