Individual
DIANNE MARIE MIKLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
788
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349690
—
MT
01
—
66069
BCBS MT
MT
01
—
670002252
RAILROAD MEDICARE
MT
Enumeration date
12/20/2006
Last updated
05/04/2015
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