Provider Demographics
NPI:1144591579
Name:MILLER, NICOLA JOAN (BS)
Entity Type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:JOAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13384 W. PORT ROYAL LANE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379
Mailing Address - Country:US
Mailing Address - Phone:623-975-3989
Mailing Address - Fax:
Practice Address - Street 1:11445 E. VIA LINDA
Practice Address - Street 2:STE. 2235
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259
Practice Address - Country:US
Practice Address - Phone:602-403-5220
Practice Address - Fax:480-391-1229
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ#SPLA74152355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant