Provider Demographics
NPI:1083645295
Name:MILLER-GRAY, CHERIE B (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:B
Last Name:MILLER-GRAY
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E NARANJA DR
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-8605
Mailing Address - Country:US
Mailing Address - Phone:520-400-8053
Mailing Address - Fax:520-901-3985
Practice Address - Street 1:1551 EAST TANGERINE ROAD
Practice Address - Street 2:OUTPATIENT THERAPY - HAND THERAPIST
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6683
Practice Address - Country:US
Practice Address - Phone:520-901-3580
Practice Address - Fax:520-901-3985
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ770645Medicaid
AZZ64187Medicare PIN