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General NPI Number Information
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NPI Number | 1841469392
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Entity Type | Individual
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Provider Name | SUSAN L MILLER MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 6320 N QUAIL HOLLOW RD
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City | MEMPHIS
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State | TN
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Zip | 38120-1420
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Country | US
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Telephone | 901-761-0021
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Fax | 901-432-5215
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Provider Business Mailing Address
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Address Line | 5469 SOUTHWOOD DR
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City | MEMPHIS
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State | TN
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Zip | 38120-1928
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Country | US
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Telephone | 901-761-0021
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Fax | 901-432-5215
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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 | SP0000000682
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License Number State | TN
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