Healthcare Provider Details

I. General information

NPI: 1962821595
Provider Name (Legal Business Name): VERONICA MILLER OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA MILLER OTR/L,CHT

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E WASHINGTON ST
MEDINA OH
44256-2170
US

IV. Provider business mailing address

6596 STATE RD
WADSWORTH OH
44281-9726
US

V. Phone/Fax

Practice location:
  • Phone: 330-721-5009
  • Fax: 330-721-4913
Mailing address:
  • Phone: 330-721-5009
  • Fax: 330-721-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number2986
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: