Healthcare Provider Details

I. General information

NPI: 1922643402
Provider Name (Legal Business Name): VERONICA JEAN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 CLEVELAND RD
WOOSTER OH
44691-2203
US

IV. Provider business mailing address

4339 VALLEY RD
WOOSTER OH
44691-9121
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-9699
  • Fax:
Mailing address:
  • Phone: 330-466-0872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: