Provider Demographics
NPI:1457351157
Name:MILLER, ANGELA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-9704
Mailing Address - Country:US
Mailing Address - Phone:717-263-7713
Mailing Address - Fax:
Practice Address - Street 1:142 FRANKLIN FARM LANE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202
Practice Address - Country:US
Practice Address - Phone:717-263-5147
Practice Address - Fax:717-263-3454
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004037L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01363102OtherCAPITAL BLUE CROSS
PA279588OtherMAMSI
PA001797549, 171OtherMEDICAL ASSISTANCE
PAMI2276OtherHIGHMARK BLUE SHIELD
PA01363102OtherCAPITAL BLUE CROSS