Provider Demographics
NPI:1447407879
Name:MILLER, COURTNEY MONIQUE (OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MONIQUE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:COURTNEY
Other - Middle Name:MONIQUE
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:865 PARKWOOD DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3583
Mailing Address - Country:US
Mailing Address - Phone:251-344-7006
Mailing Address - Fax:251-344-0826
Practice Address - Street 1:101 VILLA DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4653
Practice Address - Country:US
Practice Address - Phone:251-304-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2333225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist