Individual
ANDREA KOTYS MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SP
Contact information
Practice address
1730 KERNERSVILLE MEDICAL PKWY STE 201, KERNERSVILLE, NC 27284-7198
(336) 996-7001
Mailing address
PO BOX 601791, CHARLOTTE, NC 28260-1791
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11686
NC
235Z00000X
Speech-Language Pathologist
SP6360
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095254
—
OH
Enumeration date
02/14/2007
Last updated
11/02/2021
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