Provider Demographics
NPI:1740992031
Name:MILLER, KATHERINE SCARLETT
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SCARLETT
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 1:978 CATBIRD CT APT 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3533
Mailing Address - Country:US
Mailing Address - Phone:317-270-8903
Mailing Address - Fax:
Practice Address - Street 1:978 CATBIRD CT APT 2
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3533
Practice Address - Country:US
Practice Address - Phone:317-270-8903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000007605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist