Provider Demographics
NPI:1265710768
Name:MILLER, ELAINE JULIA (OTR ,DC)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:JULIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR ,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 CROWN ST
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1069
Mailing Address - Country:US
Mailing Address - Phone:215-295-7707
Mailing Address - Fax:
Practice Address - Street 1:714 CROWN ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1069
Practice Address - Country:US
Practice Address - Phone:215-295-7707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001606L225X00000X
FLOT 13669225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist