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Individual

DEJOUNDLA ANITA MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
26721 HAWKS PRAIRIE BLVD, KATY, TX 77494-7797
(281) 234-2367
Mailing address
24918 BLUE MOUNTAIN PARK LN, KATY, TX 77493-4018
(504) 813-4261

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
3954
NM
235Z00000X
Speech-Language Pathologist
Primary
105221
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
457
NM
Enumeration date
12/20/2006
Last updated
10/19/2022
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