Healthcare Provider Details

I. General information

NPI: 1750029955
Provider Name (Legal Business Name): CHANEIL MILLER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 20TH AVE SW STE 2
MINOT ND
58701-6452
US

IV. Provider business mailing address

2200 20TH ST SW
JAMESTOWN ND
58401-7500
US

V. Phone/Fax

Practice location:
  • Phone: 701-858-0009
  • Fax:
Mailing address:
  • Phone: 701-252-3850
  • Fax: 701-952-5249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: