Provider Demographics
NPI:1437465499
Name:MILLER, GRACE ANN-MARIE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:GRACE
Middle Name:ANN-MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 AQUEDUCT PL
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1502
Mailing Address - Country:US
Mailing Address - Phone:914-751-6735
Mailing Address - Fax:
Practice Address - Street 1:25 AQUEDUCT PL
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1502
Practice Address - Country:US
Practice Address - Phone:914-751-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014015225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist