Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 04203 | MD |
NPI | 1003242041 |
---|---|
Provider Name | Stephanie B. Miller |
First Address | Kennett Square, PA 19348-3109 |
Second Address | Baltimore, MD 21212-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2013 |
Last Update Date | 23/09/2013 |