Provider Demographics
NPI:1023448818
Name:MILLER, ALLISON K (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:K
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-3609
Mailing Address - Country:US
Mailing Address - Phone:269-370-3137
Mailing Address - Fax:
Practice Address - Street 1:3109 E BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-4372
Practice Address - Country:US
Practice Address - Phone:574-266-4508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XG0600X
MI5201008461225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology