Provider Demographics
NPI:1528396744
Name:MILLER, JULIANA OLSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:OLSON
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CAIRNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4819
Mailing Address - Country:US
Mailing Address - Phone:803-772-8606
Mailing Address - Fax:803-772-8606
Practice Address - Street 1:3700 CAIRNBROOK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4819
Practice Address - Country:US
Practice Address - Phone:803-772-8606
Practice Address - Fax:803-772-8606
Is Sole Proprietor?:No
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2634235Z00000X
GASLP004216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist