Provider Demographics
NPI:1386818771
Name:MILLER, DEOBRA LEIGH (MED CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEOBRA
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W. CENTER ST.
Mailing Address - Street 2:
Mailing Address - City:LEIPSIC
Mailing Address - State:OH
Mailing Address - Zip Code:45856
Mailing Address - Country:US
Mailing Address - Phone:419-943-2558
Mailing Address - Fax:
Practice Address - Street 1:240 NORTHCREST DR
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545
Practice Address - Country:US
Practice Address - Phone:419-599-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist