Provider Demographics
NPI:1043463078
Name:MILLER, DENISE NELSON (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:NELSON
Last Name:MILLER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3058 DAUPHIN SQUARE CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-2500
Mailing Address - Country:US
Mailing Address - Phone:251-479-4900
Mailing Address - Fax:251-479-4998
Practice Address - Street 1:3058 DAUPHIN SQUARE CONNECTOR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2500
Practice Address - Country:US
Practice Address - Phone:251-479-4900
Practice Address - Fax:251-479-4998
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0640225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890014800OtherO.T.