Provider Demographics
NPI:1760888986
Name:MILLER, MARGARET (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:ENGLER MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:34 S BLACKHAWK ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-2623
Mailing Address - Country:US
Mailing Address - Phone:608-449-3462
Mailing Address - Fax:
Practice Address - Street 1:34 S BLACKHAWK ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-2623
Practice Address - Country:US
Practice Address - Phone:608-449-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-16
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.002353172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker