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General NPI Number Information
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NPI Number | 1306636410
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Entity Type | Individual
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Provider Name | MACKENZIE ANN MILLER OTD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 3809 S 2ND ST STE D200
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City | AUSTIN
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State | TX
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Zip | 78704-7191
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Country | US
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Telephone | 512-441-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 576 GINSBERG DR
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City | SCHERTZ
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State | TX
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Zip | 78154-3082
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Country | US
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Telephone | 210-563-3809
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 125661
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License Number State | TX
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