Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201008461 | MI |
N | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1023448818 |
---|---|
Provider Name | Allison K Miller |
First Address | Elkhart, IN 46516-3609 |
Second Address | Elkhart, IN 46514-4372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2013 |
Last Update Date | 02/10/2020 |