Healthcare Provider Details

I. General information

NPI: 1477467686
Provider Name (Legal Business Name): LATONYA RENEE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7823 DEER CROSSING DR
MASON OH
45040-8262
US

IV. Provider business mailing address

7823 DEER CROSSING DR
MASON OH
45040-8262
US

V. Phone/Fax

Practice location:
  • Phone: 513-601-3232
  • Fax:
Mailing address:
  • Phone: 513-601-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: