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NPI Code Detail

MEDICARE: MICHELLE LYNN MILLER M.A. CCC-SLP

MEDICARE: MICHELLE LYNN MILLER M.A. 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 Pathologist7995NC

General Provider Information

NPI Number : 1972770451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LYNN MILLER M.A. CCC-SLP
Provider Business Mailing Address
First Line : 304 JUDD PLACE DR
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2386
Country : US
Telephone Number : 919-557-8305
Fax Number : 919-557-8306
Provider Business Practice Location Address
First Line : 304 JUDD PLACE DR
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2386
Country : US
Telephone Number : 919-557-8305
Fax Number : 919-557-8306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2008
Last Update Date : 10/03/2014

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Directions to “ MICHELLE LYNN MILLER M.A. CCC-SLP” Practice Location

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