Provider Demographics
NPI:1952686172
Name:MILLER, ALEJANDRA (MS TSLD SLP)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS TSLD SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DEKALB AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-6450
Mailing Address - Country:US
Mailing Address - Phone:646-322-5081
Mailing Address - Fax:
Practice Address - Street 1:60 MADISON AVE 8TH FLOOR
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:646-322-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist