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General NPI Number Information
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NPI Number | 1497022966
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Entity Type | Individual
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Provider Name | AMELIA K MILLER
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Gender | Female
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 1505 PATTON DR
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City | MAHOMET
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State | IL
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Zip | 61853-8116
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Country | US
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Telephone | 217-586-3749
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Fax |
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Provider Business Mailing Address
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Address Line | 2112 O DONNELL DR
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City | CHAMPAIGN
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State | IL
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Zip | 61821-6467
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Country | US
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Telephone | 512-750-7888
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.010019
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License Number State | IL
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