Provider Demographics
NPI:1568809424
Name:MILLER, M KATHERINE (SLP)
Entity Type:Individual
Prefix:MS
First Name:M
Middle Name:KATHERINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:M
Other - Middle Name:KATHERINE
Other - Last Name:MILLER-DANCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:621 E 66TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1157
Mailing Address - Country:US
Mailing Address - Phone:816-333-5670
Mailing Address - Fax:
Practice Address - Street 1:11900 JESSICA LN
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-2649
Practice Address - Country:US
Practice Address - Phone:816-743-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01376235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist