Provider Demographics
NPI:1609106152
Name:MILLER, RALEEN ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:RALEEN
Middle Name:ANN
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:PO BOX 1687
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20849-1687
Mailing Address - Country:US
Mailing Address - Phone:301-793-1335
Mailing Address - Fax:
Practice Address - Street 1:460 L ST NW
Practice Address - Street 2:817
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2546
Practice Address - Country:US
Practice Address - Phone:202-898-9364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP 000156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCSLP 000156OtherD.C. LICENSE