Provider Demographics
NPI:1336299569
Name:MILLER, LENORE DANIELS (SCD CCCSLP)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:DANIELS
Last Name:MILLER
Suffix:
Gender:F
Credentials:SCD CCCSLP
Other - Prefix:DR
Other - First Name:LENORE
Other - Middle Name:W
Other - Last Name:DANIELS MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SCD CCCSLP
Mailing Address - Street 1:46 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1709
Mailing Address - Country:US
Mailing Address - Phone:617-630-9668
Mailing Address - Fax:617-630-9669
Practice Address - Street 1:46 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460-1709
Practice Address - Country:US
Practice Address - Phone:617-630-9668
Practice Address - Fax:617-630-9669
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist