Individual
MITZI NICOLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
101 TARA OAK DR, CARENCRO, LA 70520-5776
(337) 305-3544
Mailing address
101 TARA OAK DR, CARENCRO, LA 70520-5776
(337) 305-3544
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6108
LA
235Z00000X
Speech-Language Pathologist
SLP12950
AZ
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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