Provider Demographics
NPI:1396248704
Name:DR. DAISY MILLER AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:DR. DAISY MILLER AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP PRACTICE OWNER/NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LDN
Authorized Official - Phone:301-356-4766
Mailing Address - Street 1:6112 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1004
Mailing Address - Country:US
Mailing Address - Phone:301-356-4766
Mailing Address - Fax:
Practice Address - Street 1:121 CONGRESSIONAL LN STE 701
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1562
Practice Address - Country:US
Practice Address - Phone:301-356-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDN00270133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty