Provider Demographics
NPI:1417284282
Name:MILLER, CHRISTINE S (MS, CCC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ORCHARD PL
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-2372
Mailing Address - Country:US
Mailing Address - Phone:508-476-2892
Mailing Address - Fax:
Practice Address - Street 1:76 OTIS ST
Practice Address - Street 2:#7
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3315
Practice Address - Country:US
Practice Address - Phone:508-898-2688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2166-W235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist