MEDICARE: MACY 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	SP.16000	OH

General Provider Information

NPI Number	:	1407693823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACY MILLER

Provider Business Mailing Address
First Line	:	501 N 2ND ST
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-6667
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 N 2ND ST
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-6667
Country	:	US
Telephone Number	:	513-605-6016
Fax Number	:

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

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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Directions to “ MACY MILLER ” Practice Location

Language	Start Address	Practice Location

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