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General NPI Number Information
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NPI Number | 1518267046
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Entity Type | Individual
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Provider Name | CORIN M MILLER CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 4645 S CLYDE MORRIS BLVD SUITE 407
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City | PORT ORANGE
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State | FL
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Zip | 32129-3004
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Country | US
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Telephone | 866-450-7279
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Fax |
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Provider Business Mailing Address
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Address Line | 11 HILL DR
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City | HOOSICK FALLS
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State | NY
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Zip | 12090-9764
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Country | US
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Telephone | 518-421-4256
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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 | 019755
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202006702
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License Number State | VA
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