Healthcare Provider Details

I. General information

NPI: 1295640522
Provider Name (Legal Business Name): MICHELLE M MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE MARIE MILLER

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CORNING RD
CARY NC
27518-9229
US

IV. Provider business mailing address

1901 BANKSIDE PT
APEX NC
27502-2508
US

V. Phone/Fax

Practice location:
  • Phone: 919-431-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5348
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: