Provider Demographics
NPI:1922590314
Name:MILLER, MARIE (MT-BC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13A MORSE ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901-2233
Mailing Address - Country:US
Mailing Address - Phone:603-988-4291
Mailing Address - Fax:
Practice Address - Street 1:13A MORSE ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03901-2233
Practice Address - Country:US
Practice Address - Phone:603-988-4291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist