Provider Demographics
NPI:1326357385
Name:MILLER, VERN HANSEN (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:VERN
Middle Name:HANSEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 E MAIN ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:SHIREMANSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6426
Mailing Address - Country:US
Mailing Address - Phone:724-421-7268
Mailing Address - Fax:
Practice Address - Street 1:4601 LOCUST LN
Practice Address - Street 2:STE 202
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4444
Practice Address - Country:US
Practice Address - Phone:717-526-2111
Practice Address - Fax:717-526-2117
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA09578225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist