Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 13461 | NC |
Y | 225XL0004X | Low Vision | 13461 | NC |
NPI | 1114531092 |
---|---|
Provider Name | Meredith Miller |
First Address | Raleigh, NC 27616-4345 |
Second Address | Cary, NC 27518-7438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 19/10/2020 |