Provider Demographics
NPI:1205049749
Name:MILLER, HEATHER L
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6132 COUNTY ROAD 51
Mailing Address - Street 2:
Mailing Address - City:BIG PRAIRIE
Mailing Address - State:OH
Mailing Address - Zip Code:44611-9658
Mailing Address - Country:US
Mailing Address - Phone:330-378-2091
Mailing Address - Fax:419-281-4605
Practice Address - Street 1:6132 COUNTY ROAD 51
Practice Address - Street 2:
Practice Address - City:BIG PRAIRIE
Practice Address - State:OH
Practice Address - Zip Code:44611-9658
Practice Address - Country:US
Practice Address - Phone:330-378-2091
Practice Address - Fax:419-281-4605
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator