MEDICARE: LAURA L MILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1306077714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L MILLER

Provider Business Mailing Address
First Line	:	4131 ANDREW JACKSON PKWY
Second Line	:	VILLA-402
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2270
Country	:	US
Telephone Number	:	615-612-7602
Fax Number	:

Provider Business Practice Location Address
First Line	:	4131 ANDREW JACKSON PKWY
Second Line	:	VILLA-402
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2270
Country	:	US
Telephone Number	:	615-612-7602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2009
Last Update Date	:	08/03/2009

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Directions to “ LAURA L MILLER ” Practice Location

Language	Start Address	Practice Location

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