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Individual

MRS. BETTINA MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2347 SUMMERCREEK DR APT 90, SANTA ROSA, CA 95404-7765
(708) 941-9116
Mailing address
18357 ABERDEEN ST, HOMEWOOD, IL 60430-3523
(708) 941-9116
(708) 960-0413

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146000568
IL
235Z00000X
Speech-Language Pathologist
Primary
24040
CA

Other

Enumeration date
08/14/2014
Last updated
03/30/2020
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