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NPI Code Detail

MEDICARE: SUSAN L MILLER MS CCC-SLP

MEDICARE: SUSAN L MILLER MS 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 PathologistSP0000000682TN

Other Identifiers

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

General Provider Information

NPI Number : 1841469392
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN L MILLER MS CCC-SLP
Provider Business Mailing Address
First Line : 5469 SOUTHWOOD DR
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-1928
Country : US
Telephone Number : 901-761-0021
Fax Number : 901-432-5215
Provider Business Practice Location Address
First Line : 6320 N QUAIL HOLLOW RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-1420
Country : US
Telephone Number : 901-761-0021
Fax Number : 901-432-5215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2008
Last Update Date : 11/15/2011

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