Provider Demographics
NPI:1023881620
Name:MILLER, DELESLINE (EDD)
Entity type:Individual
Prefix:DR
First Name:DELESLINE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:DEE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5414 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-9024
Mailing Address - Country:US
Mailing Address - Phone:843-437-4597
Mailing Address - Fax:
Practice Address - Street 1:5414 OVERLAND TRL
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-9024
Practice Address - Country:US
Practice Address - Phone:843-437-4597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No171M00000XOther Service ProvidersCase Manager/Care Coordinator