Healthcare Provider Details

I. General information

NPI: 1285579888
Provider Name (Legal Business Name): MAUREEN MILLER MS CCC-SLP
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 POND ST
REHOBOTH MA
02769-1726
US

IV. Provider business mailing address

30 POND ST
REHOBOTH MA
02769-1726
US

V. Phone/Fax

Practice location:
  • Phone: 774-526-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP9579
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: