Provider Demographics
NPI:1093154536
Name:MILLER, SUSAN DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DENISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:20288 HIGHWAY 15 N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-5684
Mailing Address - Country:US
Mailing Address - Phone:320-587-2326
Mailing Address - Fax:320-234-6358
Practice Address - Street 1:20288 HIGHWAY 15 N
Practice Address - Street 2:SUITE 100
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-5684
Practice Address - Country:US
Practice Address - Phone:320-587-2326
Practice Address - Fax:320-234-6358
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN101451225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing