Provider Demographics
NPI:1780883967
Name:MILLER, SARAH LEANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LEANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:ELSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1300 MCGEE DRIVE,
Mailing Address - Street 2:SUITE 113
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5858
Mailing Address - Country:US
Mailing Address - Phone:405-366-7898
Mailing Address - Fax:405-366-0010
Practice Address - Street 1:705 26TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6367
Practice Address - Country:US
Practice Address - Phone:405-308-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK3429235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200112630AMedicaid