Provider Demographics
NPI:1114048501
Name:MILLER, ANDRIA LYNNE (MS SLP)
Entity Type:Individual
Prefix:MS
First Name:ANDRIA
Middle Name:LYNNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 CLOVER HILL RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-6105
Mailing Address - Country:US
Mailing Address - Phone:717-871-9126
Mailing Address - Fax:
Practice Address - Street 1:600 EDEN RD BUILDING I
Practice Address - Street 2:S JUNE SMITH CENTER
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-299-4829
Practice Address - Fax:717-295-3453
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL0063332L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018896500002Other17