Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1023153467 |
---|---|
Provider Name | Ms. Jennifer Mary Miller |
First Address | Santa Barbara, CA 93111-2037 |
Second Address | Santa Barbara, CA 93111-2037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 22/03/2019 |