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NPI Code Detail

MEDICARE: JENNIFER G MILLER CCC-SLP

MEDICARE: JENNIFER G MILLER CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP1202AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0298870OTHERAZBCBS NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285688648
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER G MILLER CCC-SLP
Provider Business Mailing Address
First Line : 1035 N ELLSWORTH RD STE 107
Second Line :
City : MESA
State : AZ
Zip : 85207-5144
Country : US
Telephone Number : 602-628-3798
Fax Number :
Provider Business Practice Location Address
First Line : 1035 N ELLSWORTH RD STE 107
Second Line :
City : MESA
State : AZ
Zip : 85207-5144
Country : US
Telephone Number : 602-628-3798
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 06/26/2025

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Directions to “ JENNIFER G MILLER CCC-SLP” Practice Location

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