Kelley Miller, SLP
Individual provider Active NPI Speech-Language Pathologist · Balt, MD
NPI 1295814218 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295814218
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 04920 (MD)
- Practice address
- 1026 Cromwell Bridge Rd
Balt, MD 21286-3308 - Phone
- (410) 583-1515
- Fax
- (410) 583-2491
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04920 | MD | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 04920 | MD | Yes |
Addresses
Primary practice location
1026 Cromwell Bridge Rd
Balt, MD 21286-3308
Mailing address
226 Lodge Cliff CT
Abingdon, MD 21009-2518
Phone (410) 583-1515
Other providers in Balt, MD
All providers in Balt, MD · Speech-Language Pathologist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.