Provider Demographics
NPI:1831796507
Name:MILLER, MAGGIE CHRISTINE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MAGGIE
Middle Name:CHRISTINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 NW 83RD LN
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-1132
Mailing Address - Country:US
Mailing Address - Phone:954-243-4956
Mailing Address - Fax:
Practice Address - Street 1:3670 NW 83RD LN
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-1132
Practice Address - Country:US
Practice Address - Phone:954-243-4956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45762355S0801X
FL21269235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant