Nicole Miller

Individual provider Active NPI Occupational Therapist · Deckerville, MI

NPI 1164901971 · NPPES record last updated Aug 13, 2018

Key facts

NPI
1164901971
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201008429 (MI)
Practice address
3387 Ella St
Deckerville, MI 48427-7720
Phone
(989) 751-7243
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5201008429MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanilac County Current Accepting new patients
Sanilac County Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201008429 MI Yes

Addresses

Primary practice location

3387 Ella St
Deckerville, MI 48427-7720

Mailing address

3755 N Graf Rd
Caro, MI 48723-9782
Phone (989) 751-7243

Other providers in Deckerville, MI

All providers in Deckerville, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.