Provider Demographics
NPI:1659998532
Name:MILLER, DANIELLE THERESE (RD)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:THERESE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 COLDSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3703
Mailing Address - Country:US
Mailing Address - Phone:216-406-2811
Mailing Address - Fax:
Practice Address - Street 1:3025 SCIENCE PARK DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7333
Practice Address - Country:US
Practice Address - Phone:216-455-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1091158133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty