Healthcare Provider Details

I. General information

NPI: 1891655775
Provider Name (Legal Business Name): ZOE MARIE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 DRURY LN
STONEHAM MA
02180-3206
US

IV. Provider business mailing address

3 DRURY LN
STONEHAM MA
02180-3206
US

V. Phone/Fax

Practice location:
  • Phone: 781-640-4758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDNNE101197
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: