Active NPI
Gloria Miller, MS, CCC-SLP
- Speech-Language Pathologist
- Havre de Grace, MD
National Provider Identifier
1588104129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 08896
- Practice address
- 650 Otsego St
Havre de Grace, MD 21078-2646 - Phone
- (910) 987-8754
- NPI assigned
- Mar 1, 2017
- Last updated
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10722 | NC | |
| Speech-Language Pathologist | 235Z00000X | O1-0001691 | DE | |
| Speech-Language Pathologist | 235Z00000X | 08896 | MD | Primary |
Addresses
Primary practice location
650 Otsego St
Havre de Grace, MD 21078-2646
Mailing address
650 Otsego St
Havre de Grace, MD 21078-2646
Other practice location 1
1700 Pamalee Dr
Fayetteville, NC 28301-2824
Phone (910) 488-2295
Other practice location 2
34 W Kapok Dr
Newark, DE 19702-6112
Phone (910) 987-8754
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08896 | MD | MD | Clinical Social Worker |
| O1-0001691 | DE | MD | Speech-Language Pathologist |
| 10722 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1588104129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 OTSEGO ST",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210782646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 OTSEGO ST",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210782646",
"telephone_number": "910-987-8754"
}
],
"practiceLocations": [
{
"address_1": "1700 Pamalee Dr",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283012824",
"country_code": "US",
"telephone_number": "910-488-2295",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34 W Kapok Dr",
"address_purpose": "LOCATION",
"city": "Newark",
"state": "DE",
"postal_code": "197026112",
"country_code": "US",
"telephone_number": "910-987-8754",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "GLORIA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-01",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "10722",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DE",
"license": "O1-0001691",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "08896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havre de Grace, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.