Individual
TRACI A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD.
Contact information
Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002554A
IN
231H00000X
Audiologist
A.01895
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201242110
—
IN
Enumeration date
06/18/2014
Last updated
06/20/2016
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