Healthcare Provider Details

I. General information

NPI: 1669153680
Provider Name (Legal Business Name): SAVANNAH LEIGH MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 PETERSBURG RD
HACKETTSTOWN NJ
07840-4903
US

IV. Provider business mailing address

53 PETERSBURG RD
HACKETTSTOWN NJ
07840-4903
US

V. Phone/Fax

Practice location:
  • Phone: 484-624-2064
  • Fax:
Mailing address:
  • Phone: 484-624-2064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS01219800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: