Provider Demographics
NPI:1982857249
Name:MILLER, JENNIFER SANGHEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SANGHEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Other - Middle Name:
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Other - Suffix:
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Mailing Address - Street 1:2D DEER CRK
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1256
Mailing Address - Country:US
Mailing Address - Phone:518-339-9175
Mailing Address - Fax:
Practice Address - Street 1:597 3RD AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12182-2509
Practice Address - Country:US
Practice Address - Phone:518-233-0544
Practice Address - Fax:518-233-0703
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018451-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist