Provider Demographics
NPI:1821155789
Name:MILLER, ANN MARIE FERNANDEZ (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:FERNANDEZ
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 WHITE THORN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:NC
Mailing Address - Zip Code:28701-9621
Mailing Address - Country:US
Mailing Address - Phone:828-781-2220
Mailing Address - Fax:828-285-9144
Practice Address - Street 1:1063 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2650
Practice Address - Country:US
Practice Address - Phone:828-285-8814
Practice Address - Fax:828-285-9144
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1354WOtherBLUECROSS