Healthcare Provider Details

I. General information

NPI: 1144769621
Provider Name (Legal Business Name): VALERIE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7413 FIRE TOWER RD
HEBRON MD
21830-1175
US

IV. Provider business mailing address

11711 NE 12TH ST STE 3A
BELLEVUE WA
98005-2461
US

V. Phone/Fax

Practice location:
  • Phone: 443-880-3992
  • Fax:
Mailing address:
  • Phone: 813-560-8157
  • Fax: 425-452-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT60726495
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number07054
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: