Provider Demographics
NPI:1275036493
Name:MILLER, DAISY (PHD, LDN)
Entity Type:Individual
Prefix:DR
First Name:DAISY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1004
Mailing Address - Country:US
Mailing Address - Phone:301-356-4766
Mailing Address - Fax:
Practice Address - Street 1:121 CONGRESSIONAL LN STE 701
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1562
Practice Address - Country:US
Practice Address - Phone:240-449-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN00270133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist