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NPI Code Detail

MEDICARE: MRS. KELLY ELIZABETH MILLER MS, CCC-SLP

MEDICARE: MRS. KELLY ELIZABETH MILLER MS, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist242049KY

General Provider Information

NPI Number : 1790256741
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY ELIZABETH MILLER MS, CCC-SLP
Provider Business Mailing Address
First Line : 218 CEDAR VIEW LN
Second Line :
City : BEDFORD
State : IN
Zip : 47421-7251
Country : US
Telephone Number : 859-640-7056
Fax Number :
Provider Business Practice Location Address
First Line : 6301 BASS RD
Second Line :
City : PROSPECT
State : KY
Zip : 40059-9384
Country : US
Telephone Number : 502-228-8359
Fax Number : 502-228-5469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2018
Last Update Date : 12/16/2021

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Directions to “ MRS. KELLY ELIZABETH MILLER MS, CCC-SLP” Practice Location

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