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Individual

BEVERLY MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
975 MITCHELL RD, SEDALIA, MO 65301-2133
(660) 851-0668
Mailing address
975 MITCHELL RD, SEDALIA, MO 65301-2133
(660) 851-0668

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2016029041
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016029041
OTA LICENSE
MO
Enumeration date
09/14/2009
Last updated
10/24/2016
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