MEDICARE: MEGAN MILLER

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
1	225XP0200X	Pediatric Occupational Therapist	OT009875	OH

General Provider Information

NPI Number	:	1770120768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MILLER

Provider Business Mailing Address
First Line	:	9898 SUMMIT POINT DR APT 605
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-4993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6475 LESOURDSVILLE RD
Second Line	:
City	:	LIBERTY TWP
State	:	OH
Zip	:	45011-8455
Country	:	US
Telephone Number	:	513-644-1150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2019
Last Update Date	:	11/27/2023

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Directions to “ MEGAN MILLER ” Practice Location

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