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NPI Code Detail

MEDICARE: MRS. JENNIFER LYNN MILLER SLP/CCC

MEDICARE:  MRS. JENNIFER LYNN MILLER  SLP/CCC
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 Pathologist011460-1NY

General Provider Information

NPI Number : 1962687590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LYNN MILLER SLP/CCC
Provider Business Mailing Address
First Line : 211 EAGLE ST
Second Line :
City : FREDONIA
State : NY
Zip : 14063-1970
Country : US
Telephone Number : 716-679-0682
Fax Number :
Provider Business Practice Location Address
First Line : 7755 ROUTE 83
Second Line :
City : SOUTH DAYTON
State : NY
Zip : 14138-9633
Country : US
Telephone Number : 716-988-3291
Fax Number : 716-988-3864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2008
Last Update Date : 09/27/2010

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Directions to “ MRS. JENNIFER LYNN MILLER SLP/CCC” Practice Location

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