Provider Demographics
NPI:1437371622
Name:MILLER, JAIME (MA-CCC-SP)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA-CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11708 N COLLEGE AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5642
Mailing Address - Country:US
Mailing Address - Phone:317-569-0086
Mailing Address - Fax:317-569-0344
Practice Address - Street 1:11708 N COLLEGE AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5642
Practice Address - Country:US
Practice Address - Phone:317-569-0086
Practice Address - Fax:317-569-0344
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003620A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist