Individual
MRS. SHELLY ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
127 E STATE ST, GLOVERSVILLE, NY 12078-1204
(518) 773-7931
Mailing address
115 SKUNK HOLLOW RD, GLOVERSVILLE, NY 12078-6453
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004749-1
NY
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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