Individual
PHAEDRA NICOLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
355 WESTERN DR APT L, SANTA CRUZ, CA 95060-3046
(813) 966-1096
Mailing address
355 WESTERN DR APT L, SANTA CRUZ, CA 95060-3046
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
10644
CA
225XP0019X
Physical Rehabilitation Occupational Therapist
1789
CO
225XP0019X
Physical Rehabilitation Occupational Therapist
8777
FL
225XP0019X
Physical Rehabilitation Occupational Therapist
990
HI
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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