Provider Demographics
NPI:1659709616
Name:MILLER, SANDRA NARELLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:NARELLE
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 1:784D SANCHES ST
Mailing Address - Street 2:THE PRESIDIO
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-5219
Mailing Address - Country:US
Mailing Address - Phone:415-816-9192
Mailing Address - Fax:
Practice Address - Street 1:784D SANCHES ST
Practice Address - Street 2:THE PRESIDIO
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-5219
Practice Address - Country:US
Practice Address - Phone:415-816-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT13822225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist