Provider Demographics
NPI:1942324991
Name:MILLER, RONALD W (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:W
Last Name:MILLER
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7658 W BOCA RATON RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4688
Mailing Address - Country:US
Mailing Address - Phone:623-412-0997
Mailing Address - Fax:
Practice Address - Street 1:7658 W BOCA RATON RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4688
Practice Address - Country:US
Practice Address - Phone:623-412-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1363231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier