Individual
ELAENA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
634 NARAGANSETT AVE, BARABOO, WI 53913-1261
(608) 393-3554
Mailing address
634 NARAGANSETT AVE, BARABOO, WI 53913-1261
(608) 393-3554
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4925-27
WI
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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