Provider Demographics
NPI:1003124355
Name:MILLER, VANESSA R (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 SHIMMERING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-5420
Mailing Address - Country:US
Mailing Address - Phone:513-543-0834
Mailing Address - Fax:
Practice Address - Street 1:561 N POLK ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-8563
Practice Address - Country:US
Practice Address - Phone:704-889-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics