Individual
JENNIFER M MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
130 WARREN ST, SUITE 130, BEAVER DAM, WI 53916-3062
(920) 356-6409
Mailing address
130 WARREN ST, SUITE 130, BEAVER DAM, WI 53916-3062
(920) 356-6409
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
508-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001932
—
WI
Enumeration date
05/20/2008
Last updated
02/15/2010
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