Provider Demographics
NPI:1982752606
Name:MILLER, DEBRA SMITH (MS, OTR)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:SMITH
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1397 PARIS DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-8562
Mailing Address - Country:US
Mailing Address - Phone:812-343-2797
Mailing Address - Fax:317-738-9490
Practice Address - Street 1:1397 PARIS DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-8562
Practice Address - Country:US
Practice Address - Phone:812-343-2797
Practice Address - Fax:317-738-9490
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IN31001990A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200705020AMedicaid