1437371622 NPI number — JAIME MILLER M.A.-CCC-SP

NPI Number: 1437371622
Health Care Provider/Practitioner: JAIME MILLER M.A.-CCC-SP

NPI Number : 1437371622 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437371622",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILLER",
    "FirstName": "JAIME",
    "MiddleName": null,
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.A.-CCC-SP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11708 N COLLEGE AVE",
    "SecondLineMailingAddress": "SUITE 150",
    "MailingAddressCityName": "CARMEL",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46032-5642",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-569-0086",
    "MailingAddressFaxNumber": "317-569-0344",
    "FirstLinePracticeLocationAddress": "11708 N COLLEGE AVE",
    "SecondLinePracticeLocationAddress": "SUITE 150",
    "PracticeLocationAddressCityName": "CARMEL",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46032-5642",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-569-0086",
    "PracticeLocationAddressFaxNumber": "317-569-0344",
    "EnumerationDate": "05/03/2007",
    "LastUpdateDate": "09/29/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "22003620A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}