Provider Demographics
NPI:1982303293
Name:MINER, CAMILLE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MINER
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 1:17990 W LAKE HOUSTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ATASCOCITA
Mailing Address - State:TX
Mailing Address - Zip Code:77346-5195
Mailing Address - Country:US
Mailing Address - Phone:281-612-3585
Mailing Address - Fax:
Practice Address - Street 1:17990 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-5195
Practice Address - Country:US
Practice Address - Phone:281-612-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist